Mary Harney (Dublin Mid West, Progressive Democrats)

I will tell the Deputy what we are doing. This year current expenditure on health care will be €12 billion, €7 billion of which will be on primary continuing community care. Of the €7 billion, primary care and community health services get approximately €3.2 billion, which is a considerable amount of money. We are trying to strengthen the personnel and expertise available to general practitioners. As the Deputy will be aware, we made provision this year for 300 people, including physiotherapists and other therapists to be made available to primary care teams.

We also need to improve the organisation of services on the ground. At the moment, when leaving a hospital a patient's case will be reviewed by a hospital's occupational therapist. However, the occupational therapist in the community needs to go to the patient's house and those people rarely meet or talk to each other. The HSE is seeking to bring many people together. Let us consider the recently opened Ballymun health centre. Instead of people operating in many different offices in the area, they are now together. The same number of people can now provide a much better service. I understand one of the public health nurses has said that since moving to the new centre, she now spends approximately 10% of her time on the phone as opposed to the 25% she used to spend trying to talk to other colleagues. Much of what needs to be done involves bringing together the existing people on the ground. We are also increasing the number of university places for medical students and the number of training places for general practitioners. We intend to introduce graduate entry into medical school from the 2007 academic year. We are reducing the number of points required to 450, although we are still talking about the top group because the top 16% of students who do the leaving certificate get 450 points or more. We are investing in more clinical placements with a view to increasing the number of people who intend to pursue medicine as a career. It is obvious that a new contract of employment is being negotiated with the Irish Medical Organisation, which is working on behalf of general practitioners. I am a strong fan of trying to empower general practitioners to have a greater role, particularly in respect of things like chronic illness and smear testing which are more appropriate for primary care. It is clear that we have to put in place a contract of employment that incentivises that happening at that level.

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