Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

Enhanced primary care teams have been presented as a way of addressing overcrowding in hospitals and, unbelievably, as a substitute for acute hospital care in the context of the downgrading of local hospitals in areas such as Monaghan, Dundalk, Nenagh, Ennis, Cork and Kerry. How is this enhanced care in the community to be delivered under the embargo on recruitment? From where will these additional frontline health care workers come?

Everyone in the State is entitled to free inpatient hospital care but there is no universal entitlement to primary care services such as public health nurses, physiotherapists, speech and language therapists and so on. How is the Minister going to square that circle? Why is there no provision of psychiatric nursing services on primary care teams? Mental health nurses working in the community provide a different service in that they deal in the main with cases already diagnosed. To give an example, currently in the Monaghan area, owing to the non-replacement of nurses on the community mental health teams, there is a reduced ability to conduct assessments. All health care providers in the community need to be able to refer people about whom they have concerns to a qualified psychiatric nurse who is part of a primary care team. Will the Minister provide psychiatric nurses as an integral part of primary care teams? Currently, no such provision is made. What are the Minister's real plans?

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