Michael Harty (Clare, Independent)
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On a point of innovation, there is a commitment in the programme for Government to build 80 primary care centres but what we need are primary care teams rather than primary care centres. A primary care centre is a building and it might be a new shiny one but it does not necessarily guarantee that people will get new shiny services. If we had properly resourced primary care teams comprising physiotherapists, speech therapists, public health nurses, community care, social workers, speech therapists and general practitioners, that would be far more important than having a primary care building.

If the HSE is to build 80 primary care centres, it should rename them community care centres rather than primary care general practitioner centres. They tend to be built around a cohort of GPs coming into the centres to anchor the services. If a community care building was to be built, it would be far better if it was to supply diagnostic services. Diagnostic services could be taken out of the hospital and put into community care centres which would mean one would not have to travel up to 60 miles to get a scan or an X-ray. One could get those in one's community care catchment area.

Another point is that there is a huge problem in retention and recruitment of hospital staff, community staff, GPs and nurses. There does not seem to be any joined up thinking in that we educate nurses, doctors and physiotherapists but they are then left floating in the wind, so to speak, at the whim of recruitment, which can be quite restrictive. For instance, many qualified GPs are leaving the country because the system is so poor. They are probably highly indebted if they have gone through graduate entry medical school. They probably borrowed up to €100,000, which is crippling debt. People say that we have educated these doctors and ask why we are letting them leave the country. They say surely they should be committing themselves to the health service of the country that educated them. There must be a complete review because we educate these people but we let them go. We do not fight to keep them in the country.