M J Nolan (Carlow-Kilkenny, Fianna Fail)

I welcome the opportunity to speak on this motion, especially on primary care. This is one area where substantial savings can be made, but not that alone. In dealing with health matters we should not think purely in terms of cost. A positive and good service can be provided for the community through the development of primary care teams. The development of a primary care service is an essential component of the health service reform process which has been spoken about by the Minister for Health and Children over a considerable period of time.

In a developed primary care system, more than 90% of day to day health requirements and social care needs can be met. It is important that we deal with patients in a home setting in so far as this is possible and this can be accomplished by the provision of a proper primary care service. The emphasis is on keeping people in good health and supporting them so that they may live in the community rather than in institutional care. We know that the cost of institutional care far exceeds that of keeping people in the home setting. The key objective is to give them direct access to integrated multidisciplinary teams of general practitioners, nurses, physiotherapists, occupational therapists, home help carers and others. Such teams will be able to provide integrated comprehensive services to meet health and social care needs at community level. This has been characterised as providing the right care in the right place at the right time. Where it is happening, it is, indeed, very successful.

With the introduction of additional resources, which are being funded, the HSE will be working on reorganising existing professional resources in the community so that people's needs may be met in a generalist rather than a specialist manner in so far as this is possible. The Government has provided significant new funding — €44 million in total — to enable primary care teams to be rolled out. In 2005 an additional €5 million in revenue was provided, bringing the total ongoing funding to €12 million in support of the primary care strategy. Funding of €10 million was provided in 2006 to enable the establishment of up to 100 primary care teams, involving the appointments of 300 additional frontline professionals. These core teams can be further developed in the future as restructuring takes place within the HSE and as resources permit. It is money well spent. Indeed, with the ongoing increase in costs for keeping high support beds in general hospitals, it is to be encouraged that the HSE, the Minister and all involved in managing the health system should ensure that individuals, particularly the elderly, are kept in their own homes as far as possible.

Another €22 million is being provided in 2007 to meet the full year costs of the 2006 developments and to enable a further 100 primary care teams to be established. The 2006 funding was targeted by the HSE to establish up to three primary care teams in each of the 32 local health offices, which were formally known as community care areas. To achieve this objective, the HSE has identified the preferred locations for the first group of teams. There are currently 90 teams in development. This also involves placing 450 general practitioners in teams during the 2006 phase, with a further 700 GPs to join the teams in 2007. The HSE also proposes to run a recruitment competition seeking a further 300 additional front-line professionals for these primary care teams. Approximately 235 additional personnel are being offered appointments, including 77 physiotherapists, 52 occupational therapists and 80 nurses. The HSE is also exploring alternative means to provide staff when it has not been possible to recruit them.

I welcome these developments and I wish the Minister and the HSE every success in promoting this particular scheme.

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