Liam Twomey (Wexford, Fine Gael)

It is difficult to know where to start regarding this report. Much of this stems from what Mr. Derek Davis said at the IMO conference and the Tánaiste's comments afterwards criticising GPs. Again she was acting as if she was an outsider and not involved. As legislators we have responsibility for patients with medical cards and a moral responsibility for private patients. What will the Tánaiste do to ensure the country has a GP service in five years' time? This is the next crisis brewing after that in accident and emergency services. Medical card patients have difficulty in accessing GPs in some areas, which usually indicates the start of a developing crisis. It will soon start to affect private patients.

Where does the Tánaiste stand regarding the primary care strategy? We seem to be back at square one. When the former Minister for Health and Children, Deputy Martin, announced the primary care strategy in 2001, he said that 60 primary care teams would be established within five years. The Tánaiste is now making the same promise to establish 75 primary care teams five years later. When the primary care strategy was published it was a ten-year plan. Is it Government policy that it is now a 15-year plan because nothing has been done in the past five years?

The Tánaiste needs to be honest in admitting that there is a major problem in general practice and in primary care. The Tánaiste has said that GPs are not available outside of office hours and are not on call. However, Members of this House have a responsibility for one third of the population with medical cards. It is not good enough simply to pass the buck on the matter. We must determine what the Government has or has not done in this case and what it will do to correct this problem. There is no point in us coming back to the House in three years' time with the same crisis in general practice as exists in the accident and emergency service now. Accident and emergency units only cater for 3,000 patients per day whereas general practice deals with 20,000. We cannot blame the people working in the area. As the Tánaiste indicated, 1,000 GPs applied for these new posts.

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