Pat Rabbitte (Dublin South West, Labour)
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I am obliged to the Ceann Comhairle for giving me the opportunity to raise this issue. Last week, I attended the launch of a report of a community health project in my constituency entitled "Taking the First Steps to a Healthier Fettercairn". There are some 6,500 people and 840 local authority houses in Fettercairn. Development is well under way to bring the overall number of housing units to 1,000 within the next number of months.

Fettercairn is typical of the unimaginative planning and under-provision of facilities that went into large local authority estates in the 1970s and 1980s. It is an area of low income families with a large population of young people and one parent families. Some 1,511 males and 1,858 females finished full-time education aged 15 or under. Almost one fifth of all families are headed by a lone parent. Since the estate was built almost 30 years ago, the people have struggled to make the best they could from the spartan circumstances in which they found themselves. A Trinity College assessment in 2002 found "high levels of stress, smoking and chronic illness".

This report makes a number of recommendations in areas such as health, housing, transport and policing. The one recommendation I wish to highlight this evening concerns the need for a GP presence in Fettercairn given its population of 6,500 and the fact that there is no GP. The report also argues for a medical health centre, an effective primary health care team and access to pharmacy services, but it is the need for GP services that concerns me this evening.

Is there another community of soon to be 1,000 houses that is denied even clinic hours by a GP? I do not know how many towns in the Minister of State's constituency which will soon have 1,000 houses and a population rising to 6,500 people but no GP. This is directly related to the budgetary stroke by Government coming up to the 2002 general election, when it allowed the over 70s, irrespective of their means, free access to the GP. The doctors lost rich private clients in the wealthier parts of this city and so had to be incentivised by Government. The result has been that the poorer areas have been virtually denuded of GPs. What I want to know from the Minister of State is what steps she will take to ensure that something as basic as GP services are made available to the citizens of Fettercairn.

I do not want to compete with the Minister, Deputy Éamon Ó Cuív, or Deputy Mary O'Rourke in criticising the HSE but it was disconcerting to be present when the HSE representative admitted that because of manpower planning and the flight of GPs to more profitable areas, he did not believe a GP service could be provided in the area in the near future.

The Government — the Fianna Fáil-Progressive Democrats part of it — has taken specific actions the result of which has been to disadvantage the people of Fettercairn. The €1.9 billion funding promised to underpin the RAPID programme was never honoured. Now, the manner of implementation of the medical card for the over 70s has greatly disadvantaged poorer areas of urban Ireland. What action will the Minister take to address this intolerable inequality?

Máire Hoctor (Tipperary North, Fianna Fail)
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I thank the Deputy for raising this important issue. I am replying on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney.

I am conscious of the complex range of social and environmental circumstances which affect Fettercairn and a number of other disadvantaged urban areas around the country. The health services have a key role to play in working with communities and a range of other statutory and non-statutory interests to ensure a co-ordinated and integrated response in such areas. I am aware also of the research study entitled "Taking the First Steps to a Healthier Fettercairn" which was launched last week. In this regard, the Health Service Executive has confirmed to the Department that it proposes to meet the Fettercairn community health project to discuss and progress activation of the report's recommendations on health services.

The national primary care strategy aims to support and promote the health and well-being of the population by providing accessible local services and thereby reducing reliance on hospital-based services. General practice is a key part of such services in the community and will be a core element of the new primary care teams which are being developed.

The HSE has indicated that while at present there is no general practice located in the Fettercairn area, there are three GP group practices and one single-handed GP providing services within a radius of 1.5 to two miles of Fettercairn. I understand that in these circumstances persons living in the area who qualify for a medical card or GP visit card can access general practitioner services elsewhere in the Tallaght area.

The Minister for Health and Children is clear that, in the context of the development of a new contract for general practitioner services, all suitably qualified doctors should have the opportunity to have a GMS contract. Such a change has the potential to increase service availability and patient choice while at the same time facilitating more general practitioners in having access to public contracts.

The development of GP out-of-hours co-operatives throughout the country is an essential part of our health service policy of strengthening primary care services and ensuring that, to the greatest extent possible, care needs are met in the primary care setting. These co-operatives offer responsive, high quality services delivered by on duty doctors, nurses and secretarial staff in well equipped, modern clinical centres. The HSE has indicated that it is examining the feasibility of establishing a GP out-of-hours service for south-west Dublin. It has also indicated that a primary care team is being established to cater for the Brookfield-Fettercairn area and clinical team meetings are expected to commence in November. There are five GPs involved in the team, which will also include a public health nurse, occupational therapist and physiotherapist.

I understand that capital funding negotiated under the local RAPID programme has been provided towards the cost of an extension to the Fettercairn community centre, which includes accommodation for the provision of health services. The Fettercairn area will also benefit from the Tallaght west childhood development initiative which is being co-funded by the Office of the Minister for Children and Atlantic Philanthropies for the period 2007 to 2012. The projects include early childhood intervention services, a healthy schools programme, an after school programme and a community safety initiative. These projects will be subject to ongoing research and evaluation. The development of this initiative has been well grounded in partnership with the local community and this contributed to its selection as one of the three pilot sites under the prevention and early intervention programme for children which was announced last year.

The range of developments and initiatives I have outlined will contribute significantly to addressing the health service needs of the Fettercairn area.