Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

Better primary care and better social care are part of the solution to the problems in our hospitals. It is not the entire solution. The Deputy must bear in mind that if more people are seen in a primary care setting, that may result in more referrals to hospitals. On one level, more people will be managed in the community but, on another, more illness will be picked up. If we have much better primary care in Ireland, for example, doctors will start diagnosing the 50,000 to 100,000 undiagnosed diabetics in the community and even if only 10% of them have to be referred to hospital clinics, that will mean an additional 10,000 attendances. There are interplay factors and people often over-simplify this too much. There is evidence, although it is less than convincing, that GP care without fees for those under six years of age has resulted in an increase in referrals to paediatric emergency departments. I would like to see a full season's data before being convinced of that because other factors could be at play, not least the respiratory syncytial virus.

We have learned a great deal from those under six years of age and those over 70 years of age. It has been a great success but we are learning from it. There has been an increase in attendances by those under six years of age at GP services and there has been a significant increase in attendances at out-of-hours services. We have to factor all that into future planning. It will be necessary to increase the number of GPs over time and, therefore, we need to ensure there is not a mismatch between the increase in the number of GPs and trainees and what we ask them to do. That is why my party is putting forward proposals that we believe are ambitious but achievable in a five-year period. I am disappointed that the Deputy's party proposes to stop at six years of age and not extend the scheme further. That is a real shame.

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