To ask the Minister of Health, Social Services and Public Safety for an update on the ongoing review of General Practice.

Mr Hamilton

In October last year, I established a working group to review the provision of GP-led care and to make recommendations aimed at ensuring the future sustainability of GP services. That working group has been led by my Department, and its membership includes a patient representative, GP representatives and members of the Health and Social Care Board, health and social care trusts, the Royal College of Nursing and the Allied Health Professions Federation. The group has met regularly since its establishment and has considered a wide range of issues, including the recruitment and retention of GPs and how best to support the existing GP workforce. The group is finalising its report, and I expect to receive a copy in the next few days. I will, of course, give careful consideration to its findings and recommendations. I expect the working group's recommendations to build on actions that I have already taken to address the challenges that GPs face. I recently announced an investment of £1·2 million each year to commission an additional 20 GP training places, starting in 2016-17. That is the largest investment in GP training for more than 10 years and will increase the number of GP trainees to 85 per year from August 2016. In December, I announced a five-year investment initiative that will put close to 300 pharmacists in GP practices by 2021, easing pressures on GPs and ensuring that patients continue to receive a high-quality service. In addition, as part of an investment package of up to £5·1 million in 2015-16, new schemes have been introduced aimed at encouraging GPs who have left practice in Northern Ireland to return and supporting the existing GP workforce to remain in practice. Those actions are helping to ensure that the people of Northern Ireland continue to have timely access to sustainable, high-quality, GP-led primary care services.

Mr Deputy Speaker (Mr Beggs)

I ask the Member to come to her question, please.

Mr Hamilton

One issue in particular that the Member raised is not something that the Department or the board will ask GPs to do in the system. It is a matter for them to take on board themselves. Sometimes we forget that they are independent contractors, as opposed to people working directly for health trusts, the board or the Department. I accept that it is a profession that is under pressure. You just have to look at the increase in consultations. In 2008-09, there were 10·2 million consultations in Northern Ireland: that rose to 12·7 million in 2013-14, which was an increase of around a quarter. Clearly, that will put pressure on a GP workforce that is exceptionally good but is ageing, and those pressures are not helping to retain people in the system. I acknowledge the pressures. That is why a package of measures has been put in place to deal with the pressures that GPs face. I, too, have met individual GPs. I have met the Royal College of General Practitioners and the British Medical Association. On top of the funding package of around £10 million that was put in place in April last year for a GP modernisation fund, some investment in skills and some investment in developing GP federations, we have made the biggest investment in 10 years, as I noted, by increasing GP training places to deal with GPs leaving and not being able to retain them. The working group itself is a response to a call from that sector for short-, medium- and long-term recommendations. The GP pharmacist initiative is something that GPs have called for. Yes, there is a problem. We accept and acknowledge that, but we are not sitting back doing nothing. We are coming forward with a range of measures, many of which owe their origins to the profession suggesting them and the Department positively responding.

Mrs Cameron

We understand the pressures that GPs are under, and the Minister has mentioned the pharmacists in GP practices initiative. Can he outline some of the benefits of that initiative?

Mr Hamilton

It is something that I was pleased to announce towards the tail end of last year. As I mentioned in response to Ms Sugden, it was something that we had been working with GPs on. They suggested the idea, we piloted a scheme, and I was able to see a pilot scheme at the Arches practice at the bottom of the Holywood Road in Belfast. We have been announcing a five-year investment that will start off quite small. There will be £2·6 million in the next financial year, rising to £14 million by 2020-21. Over five years, that will allow us to ramp up the number of pharmacists working alongside GP practices. Some will be full-time and some part-time. Some will be shared between a couple of practices. In more rural areas, it might be one day in practices over a wider area. There are benefits in two areas. There will be financial savings. We anticipate that, by 2021, our investment will yield savings of around £16 million, so the scheme will pay for itself. There are also non-monetary benefits, including better prescribing. GPs will be able to do regular checks on what people are being prescribed and whether it is working for them. The initiative will reduce prescribing costs and increase capacity in GP surgeries. GPs will be able to use the pharmacists to remove some of the pressure that they face. Hopefully, it will also reduce the number of acute admissions. Therefore, a range of benefits, monetary and non-monetary, will be derived from this innovative initiative, which I was very pleased to announce last year.

Mr Diver

I thank the Minister for his answers to date. Minister, despite listening with interest to the range of measures that you are putting in place to help general practice, in my constituency in the west, we are aware of falling numbers of trainees coming into general practice, and the scheme is undersubscribed year after year. What effect is that having on the strategic goals for GPs in Transforming Your Care, considering that one GP said to me only today that falling numbers make the Transforming Your Care plans impossible?

Mr Hamilton

As I hope I have indicated in the answers that I have given so far, I accept that there are pressures and I acknowledge that there is an issue with general practice. That is why we have been rolling out all the various initiatives and investments that we have been making. I accept that there are some parts of the Province where the problem is particularly acute compared with others. I am not saying, for example, that there are not issues in the Belfast or greater Belfast area, but there is certainly an acuteness of the problem in the west of the Province. I recently visited not quite the Member's constituency but Fermanagh, along with the First Minister, to hear directly from GPs in that county about the difficulties that they are facing. I accept and acknowledge the problem that they are facing, because the problems about which I responded to Ms Sugden are a little more pronounced in that part of Northern Ireland. The fact that we have a GP workforce where around a quarter are over 55 seems to be a much more pronounced problem in the west of the Province. Where you have many GP practices in the west of the Province that are single or have just two GPs, that adds to the pressures that people are facing. One of the impacts of one of the initiatives, the £1·2 million investment in more GP training places, which is the biggest investment of its kind in over a decade, will see 20 more GPs go into training. Four of those GP training places will go into the Western Trust area to help to alleviate some of those problems. Obviously, that will be cumulative over the next number of years as those numbers start to move through the system. There is an issue with retention, which I am keen to address. Without having seen the response of the working group, I will be very surprised if it does not make a recommendation to do something in respect of trying to retain GPs in certain parts of the Province, particularly in the west and the north-west.