David Cullinane (Sinn Fein)

Health care should not be based on profit or, at least, access to health care should not be based on ability to pay, but on need. This is a fundamental principle I hold. This problem is one of the core difficulties with our primary health care system and it needs to be addressed as part of an overall patient-centred reform and rebuilding of primary care on the basis of need, equity and efficiency.

I hope, like other Senators, this Bill will keep many young GPs in Ireland and, perhaps, increase the number of GPs we have. I assume the Minister would agree that we need a more comprehensive approach to primary care and that the provision of general practitioner services is only one part of solving the problem. Other speakers mentioned the acute shortage of general practitioners here. For example, we have 52 GPs for every 100,000 people, in contrast to other European countries. France, for example, has 164 GPs for the same number, Austria has 144 and Germany has 102. These figures show GPs are under-represented here. It is no surprise that the limited number of GPs is most noticeable in areas of high disadvantage, which highlights the inequalities in our system. For example, Tallaght has 24 GPs for a population of 71,000.

I support the Bill because I want to ensure we have equity in the system and that we support greater numbers of new GPs coming into the system and improve access to it. However, I appeal to the Minister to see this Bill as only one part of the jigsaw in terms of reforming primary health care in this country. I know he has spoken about reform across the board in the context of the HSE, primary health care and acute services, but he should also be aware that many of our acute services the length and breadth of the country are under severe pressure because of cutbacks, the embargo on recruitment and the number of people leaving the public service. I do not want to raise all of these issues in the context of this Bill, so I appeal to the Minister and to the Leader to give us a commitment that the Minister will come back to discuss those issues constructively at another time, because we all have the best interests of the health care system at heart. We may disagree with where money is spent or on policy, but we all want to see the best health care possible provided for the people. On that basis, I hope the Minister gives a commitment to come back to discuss the issues I have not dwelled on today.