James Reilly (Dublin North, Fine Gael) | Oireachtas source

I propose to take all questions together.

The key objective of the primary care strategy is to develop services in the community which will give people direct access to integrated multidisciplinary teams of general practitioners, nurses, physiotherapists, occupational therapists and other health care disciplines. This is central to the Government's objective of delivering a high quality integrated and cost-effective health system. A modern well-equipped primary care infrastructure is central to the effective functioning of primary care teams. These teams enable multidisciplinary services to be delivered on a single site, provide a single point of access for users and encourage closer co-operation between health care providers.

The infrastructure development through a combination of public and private investment aims to facilitate the delivery of multidisciplinary primary health care and represents a tangible refocusing of the health service to deliver care in the most appropriate and lowest cost settings. The intention to date has been that where appropriate infrastructure for primary care centres would be provided by the private sector through negotiated lease agreements, the Exchequer would also fund the delivery of some primary care centres, particularly in deprived urban areas, small rural towns and isolated areas. In addition, a list of 35 potential locations for development by way of public private partnership as part of the Government's infrastructure stimulus package was developed.

Earlier this year, the HSE put together a list of high priority locations for the development of primary care centres throughout Ireland. Three criteria were deployed for selecting primary care centres: an assessment of deprivation - the deprivation index for the catchment population of the centre; the service priority identified by each integrated service area and local health office; and an accommodation assessment which assessed accommodation available for the primary care team within the catchment area, the quality of the accommodation and whether the accommodation was spread over more than one building. Other factors were considered when selecting centres for the inclusion on the PPP list. New criteria were added. It was evident, for example, that consideration needed to be given to existing health facilities or the lack thereof; GP to population ratio; pressures on services, particularly acute services; funding options, including Exchequer-funded HSE build or lease; and the implementability of a public private partnership relating to its size, site and scale. By deciding to create a list of 35 rather than 20 locations, I provided positive encouragement for engagement and financial participation by GPs in this significant and important stimulus package. When dealing with public private partnerships, PPPs, it makes sense to maximise the options available.

As I mentioned earlier, PPP is one of the three methods of delivery being considered by the HSE for the purpose of developing primary care centres. Lease and Exchequer-funded HSE builds are also under consideration. The list of 35 potential locations referred to those that may be progressed by way of the public private partnership. It is envisaged that 20 of these locations will be progressed by these means. With regard to the criteria for progressing centres, I am satisfied that the criteria I have outlined are appropriate for the selection of primary care centre locations in the future.

The HSE is engaging with the National Development Finance Agency, NDFA, as required, to progress the primary care centre element of the Government's public private partnership programme. The HSE is analysing the available sites in each location and engaging with GPs in each location to determine their interest in participating in the primary care centre development.

I wish to clarify the record of the House. In the Irish Independenttoday, it is suggested that the site owned by Mr. Murphy was effectively selected by the HSE in 2010 as the site for a primary care centre. The newspaper suggested this information was available by way of a reply to a parliamentary question tabled by me in February 2010 when I was in opposition. The relevant journalist also made that statement on "Morning Ireland". My assistants retrieved the reply to the relevant parliamentary question and the follow-up letter I received from the HSE. That letter from 1 February 2010 states: "The HSE has selected a preferred provider for expressions of interest." It goes on to say: "The proposed site will be accessible by pedestrians off Dublin Street and should be well served by Dublin Bus." The letter appears, therefore, to support the report in the Irish Independent and on "Morning Ireland". The Minister for Education and Skills, Deputy Ruairí Quinn, referred to it during Leader's Questions in the House today and I referred to it on RTE radio today as well.

I have had this double-checked with the HSE and am advised that, in fact, the reports are incorrect. In fact, the letter from the HSE in 2010 refers to another site in an area called Stephenstown, some distance from the site owned by Mr. Murphy. It appears that option ran into a number of difficulties and in November 2010, the letter of intent was withdrawn. The HSE returned to the other interested parties and ultimately selected Mr. A.J. Noonan. In September of last year, the HSE signed an agreement for lease with Mr. Noonan to develop a primary care centre. This information has been provided to us by the HSE and if Deputies want further information, it can be furnished by the HSE.

I wish to make a few general points and then allow for the questions. We cannot deliver the quality of care required at a price the country can afford through the hospital-centric model of care and we need a new integrated model of care which treats patients at the lowest level of complexity and that is safe, timely, efficient and as near to home as possible. I want to work with GPs and I want their active and direct involvement in chronic disease management. I want them to work as part of a more responsive hospital service. GPs in primary care are central to our health and well-being and we need the active support of other sectors in our economy to improve health and well-being, which are essential to the sustainable development and the economic and social interests of the country.

The PPPs will deliver jobs and the first tranche of the €115 million of investment which is vital to our construction industry. The reforms I am delivering will keep people healthy, provide the health care people need, deliver high quality services and get best value from health system resources. The new health care system and primary care system will have a number of tangible changes that patients will experience: improved health and well-being, faster and equitable access to hospital care, free access to GP care, better management of chronic illness, more people treated in their homes, and improved quality and safety.

I want primary care centres to be the campus for best care and first choice for patients. Primary care is the best solution to support an ageing and more dependent population of patients. The population growth projections estimate the population of Ireland will reach 5.7 million by 2021, and significant increases are expected across all age groups. The modern primary care unit will support children, adolescents, adults and seniors. I want every community throughout the country to have a modern and dynamic primary care centre. I want to foster a culture that promotes health and well-being across the community. Above all else, I want the best outcomes for the patients we serve.

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