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

I am grateful to the Deputy for raising this issue. I am glad to tell the House that significant progress has been made in the development of primary care centres. A total of 34 centres have been built since the Government took office. On average, one primary care centre opens every month. Some 35 primary care centre sites were originally identified to be built by PPP, 16 of which have been identified as suitable. Many of the remaining primary care centres, including the one in Ennis, should progress and could be built by operational lease or inclusion in the capital plan.

The programme for Government sets out the Government's commitment to ensuring a better and more efficient health system and a single tier health service that will deliver equal access to health care based on need, not income, which the Deputy mentioned. In a developed primary care system, up to 95% of people's day-to-day health and social care needs can be met in the primary care setting. 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 GPs, nurses, physiotherapists, occupational therapists and other health care disciplines. This is central to the Government's objective to deliver a high quality, integrated and cost effective health system. 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-ordination between health providers. The infrastructure development, through a combination of public and private investment, will 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 setting.

The intention to date has been that, where appropriate, infrastructure is provided by the private sector through negotiated lease agreements. Where service needs dictate, accommodation will be provided in primary care centres for mental health service delivery. I had the pleasure of opening a centre with Deputies Catherine Byrne and Michael Conaghan in Inchicore last Friday. Not alone is a mental health facility provided for the community there, a 50-bed long-term care facility for older people is also being provided. New arrangements are being put in place to have specialists in older people's medicine visit both the long-term unit and the primary care centre. This is part of our underlying plan and adheres to our principle of not only treating the patient at the lowest level of complexity that is safe, timely and efficient but also as near to home as possible. We must stop this idea of 50 people having to travel miles to see one person when a single specialist could travel to the centre and see the people there. That is what is happening in Mitchelstown, County Cork. Complete antenatal care is delivered in the primary care centre and patients do not have to travel to hospital in Cork to be seen unless they develop a major complication.

In 2012 the HSE embarked on a prioritisation exercise for primary care centres. However, the exercise is dynamic in nature and constantly evolving to take account of changing circumstances, including the feasibility of implementation. It is the Government's intention to develop as many primary care centres as possible using one of the following methods: direct build by the HSE funded entirely by the taxpayer, or leasing arrangements with the private sector or PPPs. Considerable progress has been made in the delivery of primary care centres and 34 centres have opened since May 2011.

Ennis was one of the 35 potential locations for primary care centres to be developed by means of a PPP, but that has changed, as GPs were not in favour of that process. Ennis remains on the HSE's schedule of primary care centres to be developed. An operational lease is being considered as the best option and it is the preferred choice of local GPs. The HSE continues to engage with potential developers who have expressed an interest with a view to making progress on this development as soon as possible. However, we will not build primary care centres that will lie idle, while GPs sit outside asking how much they will be paid to go in. That would not represent value for the taxpayer and it will not be allowed to happen.

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