Enda Kenny (Mayo, Fine Gael) | Oireachtas source

Primary care development is a fundamental part of the strategy to reform the health sector. Clearly, primary care centres have enormous capacity to take people in, rather than having them go to accident and emergency units in the first place. Given the range of facilities that can, should and will be provided in primary care centres, they are important. There were broader criteria used than just the deprivation index in the selection of primary care centres. The criteria also included the impact on acute services in hospitals, competition and GP co-operation. The Minister and the Department of Public Expenditure and Reform accepted that competition was required to ensure there would be a cost-effective GP buy-in and on that basis the number of potential primary care centre locations was determined.

It is important to note that this is part of the overall stimulus package announced by the Minister for Public Expenditure and Reform some time ago, which included expenditure in the areas of road development, schools and primary care centres.

Each of these sectors was approved by the Government following consultations by the Ministers involved with their colleagues, and the same applied in this case.

It is also important to note that early this year the HSE set out its prioritisation for primary care centres. Deputy Martin will be aware that in some locations the HSE was already at advanced stages of discussion about the development of primary care centres, including the leasing of premises by GPs for primary care, and this was deemed the most appropriate way of delivering those centres. A number of other high-priority locations were selected for direct investment by the HSE using Exchequer funds from the HSE's capital allocation, and the remaining locations were then considered as being appropriate for public-private partnership development.

Deputy Martin will be aware that if one wishes to develop 20 primary care centres and one selects only 20 possibilities, one runs the risk of objections, non-buy-in by GPs, lack of competition and other factors. What the Government approved and signed off was a list of 35 primary care centres, with 20 to be developed. That does not mean that the first 20 will actually be developed, because of the factors that I mentioned. In order to get this moving as quickly as possible, taking into account situations in which there were leases involved, an intention to lease, direct Exchequer funding or PPPs, the Minister, in consultation with his colleagues, made a recommendation to the Government and the Government signed off on that element of the stimulus package for the development of 20 primary care centres from a list of 35.

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