Ms Laura Magahy:

I thank the Senator and will take his questions in order. The reprofiling of health spending is very interesting. The Economic and Social Research Institute, ESRI, has just finished a benchmarking exercise in respect of where Ireland sits in the international context. It was quite difficult to do because we include disabilities, mental health and other definitions in our spending, whereas other jurisdictions do not.

I take the Senator's point on mental health and I am very happy to say we advanced significant funding to Jigsaw during the pandemic. Jigsaw is represented on our Sláintecare implementation advisory council. We are very aware of the work it is doing.

The Senator asked about community healthcare networks and how they link with primary care settings. The community healthcare networks are really interesting from a population planning perspective. They will be able to predict the needs of a population of an average of 50,000 people and adjust the services needed for the population. The primary care centre's role is critical in that.

The Senator asked about GP buy-in. We have a very engaged working arrangement with GPs and we meet every three weeks. We have agreed a programme of work with them that also includes looking at future strategies for GPs, especially in the terms of the topics raised by the Senator, including recruitment in a rural setting. That is a major issue for GPs. We have also agreed to fund the benchmarking and monitoring of the chronic disease management that GPs will be doing. They have kindly agreed to work in close partnership with us in healthcare pathways, which is a very interesting system. I will ask Ms Mellett to elaborate on that if we have time.

The Senator asked about relief for GPs in the context of Westdoc. We have a very interesting initiative happening this year with advance triage and this is being funded by the National Ambulance Service. If people are anxious during the night they can phone up and be directed either to a service that is local or in a hospital, with the goal being to have this staffed by GPs. We look forward to working with the ambulance service in rolling that out, as it is a very exciting initiative.

The Senator mentioned Croí, which we have funded. The work it has done on heart failure is one of the projects we have been delighted to fund. The Senator is absolutely right that this is fantastic work. It is something we will look at in terms of scaling. The example I gave during the presentation was a remote heart failure clinic that is being run by Kilkenny and St. Vincent's hospitals. There are slots available for GPs to phone in and get a senior consultant's advice on whether a patient is doing well. It is a case of not bringing in people as an outpatient but having the expertise available on tap. The new ways of working we have been able to explore during the year are exactly what the Senator inquired about.

I will ask Dr. Healy to speak about community and voluntary organisations, which are a key part of our engagement. We have been very fortunate to have the support of the community and voluntary sector in the work we are advocating. Is it possible for my colleagues to speak about health pathways and the community and voluntary piece?