Róisín Shortall (Dublin North West, Labour)

I am glad to have the opportunity to contribute to this debate. As my colleague, the Minister, already stated, our main concern and that of this Government is the safety of patients. We will not stand over unsafe services. We have been clear about that from the very beginning. We are working hard within Government to ensure that safe and appropriate health services are delivered in the most appropriate setting.

This Government recognises the important role of smaller hospitals in local communities. We believe they represent, and will continue to represent, a fundamental element of an integrated health service in their regions providing as wide a range of treatment and care as possible. The future of health care delivery is about delivering appropriate care in the appropriate setting. This will mean that some services will move from smaller hospitals to larger ones but it will also mean that services will move from larger hospitals to smaller ones. In future, we will be sure that smaller hospitals will deliver appropriate and safe care for the communities they serve. Access for GPs to services and diagnostics will form a crucial part of the development of the role of smaller hospitals.

In considering the motion, it is important to state that apart from the very many reforms which are already under way and which the Minister outlined, primary care and its development is an essential component of health service reform and in the delivery of the most appropriate care as close to the patient as is possible. In a modern and responsive health care system, up to 95% of people's day-to-day health and social care needs can be met in the primary care setting. Deputy Healy made that point earlier, and that is our intention. They are the kind of reforms towards which we are working.

It is interesting that the motion refers to things that happened as far back as 1980 and in 2008 and 2009. We have a legacy of a lot of bad decisions which were made by the previous Government. We are setting about reversing them, addressing those past mistakes and introducing the kind of fundamental reforms our health service requires.

We intend to further develop services in the community so that everyone has direct access to integrated multi-disciplinary primary care teams of general practitioners, nurses, physiotherapists, occupational therapists and others. These primary care teams will be supported by a wider range of professionals, including pharmacists, dieticians, psychologists and chiropodists. That will all happen within a health care network.

We intend to develop integrated services in which patients have access to a range of primary care services within their communities, preferably in modern buildings. This is what the public wants and deserves. It makes sense from a health point of view and gives value for money. We are determined to deliver this type of modern, responsive health care system.

We want to develop and strengthen the number of primary care teams that are in place and I intend to build on the progress already made in respect of the primary care strategy. In addition, the programme for Government commits to the removal of cost as a barrier to accessing primary care services. The clear commitment is for the delivery of free access to GP care within the Government's term. This will be my main job as the Minister of State with responsibility for primary care. The delivery cannot be done overnight. Rather, it must be done incrementally so as to build capacity in the system. We are working in this regard. We also need a separate delivery structure for primary care within the health system so that it does not compete with other demands. We need a ring-fenced budget for primary care. Side by side with that will be key reforms, such as the roll-out chronic disease programmes. These factors have the potential to transform our health services radically.

I am sorry to disappoint the Members opposite, but we will not be handing over the health system to the privateers-----

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