Richard Bruton (Dublin North Central, Fine Gael)

I move amendment No. 11:

In page 27, between lines 31 and 32, to insert the following:

20.—The Minister may, by regulations, and after consultation with the Minister for Health, introduce specific reliefs to help equip Primary Care Centres with appropriate diagnostic and treatment facilities where he is satisfied that they bring commensurate social benefits in the more effective provision of health services.".

This amendment arose from a report by the Joint Committee on Health and Children on primary care centres. There was all-party agreement that the Minister for Finance should consider the possibility of tax reliefs to encourage the establishment of such facilities.

I do not think the argument needs to be rehearsed at length but anyone who visits my part of the city would see that the lack of primary care facilities is forcing people to present to accident and emergency units in excessive numbers. If I recall the Comptroller and Auditor General's report correctly, the average cost of an accident and emergency visit is in the order of €300. Clearly, cost effectiveness would encourage the development of primary care centres with more diagnostic facilities and better capacity to deal with basic matters like blood tests. At present on the north side of Dublin doctors are charging medical card holders for blood tests, which means patients must wait several months to be tested in general hospitals. This is a very inefficient way to manage an important diagnostic tool.

It is generally believed that the proposal to fund primary care centres rather than pile patients into overstretched acute hospitals deserves our support. I framed this amendment in a way that is not overly prescriptive. It accords with the Minister's expectation in the area of tax reliefs, namely, that the costs are commensurate with the benefits. It also fits with general policy for the sector, in other words, the Department of Health and Children would accept it as a coherent way of delivering health services.

This amendment would at least enable the Minister for Finance to consider the report of the joint committee and if he and the Minister for Health and Children agree with it, he would have the statutory power to progress it. They may not agree to it after considering the issues. The Minister is under no obligation in this amendment. Given the state of thinking about the matter, I believe the amendment would give the Minister a weapon in his toolbox which, hopefully, he could use if it is seen as a good way to develop health policy. He is protected by his right to ask the Department of Health and Children to do the necessary cost benefits and then revert and show and convince him it is a good way to spend public money.

We all realise that whether it is a tax relief or a spending item, taxpayers' money is at stake. I did not draw the amendment so widely that it would support mortgages and property development. I realise there would be a degree of unease about mortgage-based tax reliefs given their history. That does not apply in the case of diagnostics and treatment and it may be a way of facilitating a better social policy that appears to command support across the House.

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