General practitioners, GPs, are the cornerstone of our primary care services. Primary care is at the front line of health service provision and deals with the bulk of the health needs of our population. It has lower costs than acute care and can deliver a better preventative quality of care faster and closer to home. I do not need to emphasise the importance of our GPs but for the avoidance of doubt, last year according to the Irish College of General Practitioners approximately 25 million patients were seen in Irish general practices. That is a sensational performance, particularly when it is factored in that the care that is delivered is world class. It is even more sensational when it is factored in what the Government has done to general practitioners and primary care through savage funding cuts.

The Government cut 38% from general practice under FEMPI legislation and there has been a steadfast refusal to reverse this. The Government claimed the budget would signal that Ireland had exited recession. That is absolutely meaningless to GPs, those working in primary care or those who need access to primary care services. What the Government is doing does not make any sense in terms of healthcare or economics. The Government has exhibited an absolute poverty of imagination when it comes to addressing the problems in primary care. Instead of investing properly in our GPs and primary care, which is much cheaper than secondary acute care, the Government prefers to starve the sector. The result is that our GP network is now close to collapse. The Government's actions, particularly in this year's budget, have done little to address the recruitment and retention crisis among GPs because nothing has been done to reverse FEMPI measures. It has made no progress on the GP contract negotiations. Instead, it produced a report yesterday claiming €100 million could be saved in efficiencies to completely undermine GPs. This represents a poor start to the contract negotiations. GPs are operating at and above capacity in a primary care system creaking with problems and the Government has the cheek to throw out reports claiming GPs and practice nurses are inefficient. GP practices in my area, particularly in Swords and Balbriggan, are closed to new entrants. I do not know how GP practices can become more efficient. Suggesting that GPs and practice nurses are not working to full capacity is nothing short of insulting. General practice is in crisis and the Government refuses to acknowledge it or do anything meaningful to address it.

Considering the recent restoration of Deputies' salaries by the Government, when does it plan to reverse FEMPI in respect of primary care, which took a disproportionate 38% cut during the austerity years? When can GPs expect negotiations on a new contract to be concluded? What concrete steps is the Government taking to increase capacity in primary care?

A big part of Sláintecare and the Government's health strategy is about investing in primary care to keep people out of hospitals in the first place, as the Deputy will be well aware. That is why we have invested tens of millions of euro in primary care facilities throughout the country in many of the towns, cities and constituencies represented in this House. As announced in this week's Budget Statement, 100,000 more people will qualify for free GP care due to the changes we are making in qualifying thresholds. This is intended to make life easier for families to help with health costs which we have also done by reducing the cost of medicines. This is also in line with Sláintecare.

Separately in budget 2019, the Minister for Health, Deputy Harris, secured significant funds to invest in general practice. We recognise that GPs need to be supported in a sustainable manner to deliver the increased services we are asking them to deliver. We also want to deliver on the Sláintecare reforms to move more care into the community, which is better for everybody. We need to ensure general practice is ready and able to do that and we are investing in that. We have a significant multi-annual investment to make, which is worth many millions of euro. Irish Medical Organisation, IMO, officials were in the Department of Health yesterday and I expect to see progress soon on a process the Government and the Minister for Health are eager to see delivering an agreement as quickly as possible. We are about trying to reverse cuts of recent years; we are doing it across all sectors.

My note tells me the Sinn Féin budgetary position did not even provide for the development of a new GP contract.

The Tánaiste's note is incorrect.

The Deputy might send me information on that if I am wrong.

I will be happy to.

The Minister for Health is at the point-----

This is Leaders' Questions.

-----of trying to get agreement with the IMO on primary care and creating a supportive environment for GPs to be able to provide expanded services which we are both planning for an investing in through the budget this week.

Scotland has 4,953 GPs for a population of 5.2 million. Wales has 2,887 for a population of 3 million. We have 2,500 in the State to cover a population of 4.7 million. Where are the tens of millions of euro the Tánaiste referred to going? Every time I ask a question about the development of primary care services, I get the same answer, which is services will be provided from within existing resources. We will be 1,000 GPs short over the next decade. More people do not have an entitlement to access their GPs. They will go onto a waiting list and wait like everybody else for healthcare. Seven in ten GPs can no longer take on new patients. Where will the new patients go? The Government is doing nothing to address the underlying causes of these problems. When does the Government plan to reverse the FEMPI legislation completely for GPs? When will the negotiations be concluded? What concrete steps will the Government take to increase capacity, which is key? Making a promise it cannot keep seems to have become the hallmark of this Government. It is telling people they will now have access to a GP when seven in ten GPs in the State are saying they will not take on any new patients.

I am not aware the Deputy's party made a promise in its pre-budget submission on a new GP contract.

As I told the Tánaiste, we did.

Perhaps the Deputy can send me the detail on it.

I will send it. As Deputy Coppinger pointed out, this is Leaders' Questions.

I notice the Deputy has not referred to it.

There is somebody in the Deputy's office going through it right now-----

This is Leaders' Questions, so, with respect-----

I will answer the questions.

-----I ask the questions.

The Tánaiste is not here to ask us questions.

I will answer the questions. It is important that if the Deputy is making accusations across the House that she takes a look in the mirror. On the resources that are needed to expand our primary healthcare system, we are providing an additional €1.2 billion for healthcare next year, which is a massive increase in health expenditure. Much of it will go into primary care. I have stood in some of the new primary healthcare facilities in various constituencies. There are many of them and GPs are moving into them to try to improve the facilities that GPs operate in.

There is no staff in them.

With regard to the financial resources that are needed for a new GP contract to ensure GPs are fairly paid for the increased workload we are asking them to take on, negotiations are going on right now and the Department of Health hopes to make progress with the IMO. We had meetings on that issue as late as yesterday.