James Reilly (Dublin North, Fine Gael)
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Question 3: To ask the Minister for Health and Children the reason the primary care strategy has not been rolled out in line with the commitments given in the social partnership agreement, Towards 2016, which promised the delivery of 300 teams by 2008; and if she will make a statement on the matter. [22487/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The key objective of the primary care strategy is to give people direct access to integrated multi-disciplinary teams of general practitioners, nurses, physiotherapists, occupational therapists, home helps and others. It is clear that the membership of primary care teams and networks are drawn from existing professional and other staff working in primary, continuing and community care services, and that there would also be a major enhancement of the level and nature of services available in those settings.

There have been substantial enhancements in the services provided in primary and community care settings with corresponding increases in the numbers of staff concerned. At this stage, the main focus needs to be on the reorganisation of existing services and staff into primary care teams and networks. This requires changes in work practices and reporting relationships, with an emphasis on joint working by various health professionals. It also requires significant work in mapping and profiling of areas. Work under many of these headings is well advanced and I am pleased with the level of interest in, and engagement with, primary care teams among general practitioners. I understand that 500 general practitioners are involved in the development of teams, with a further 700 projected to become involved.

Specific additional funding was provided the years from 2006 to 2008 to facilitate the roll-out of extra primary care teams. Some of this funding was used to appoint extra front line professional staff. I emphasised to the HSE the importance I attach to the continued development and roll-out of primary care teams.

James Reilly (Dublin North, Fine Gael)
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The Government announced the primary health care strategy way back in 2001. Now seven years later all we have are virtual teams. I believe that there might be ten or 11 projects that have seen the light of day. When the Minister talks about the funding, is it not the case that in many of the areas where 13 were supposed to be put in place, three ended up being appointed. While it is clear to me and others involved in primary care, the question must be asked as to whether the primary care strategy is dead. The original funding will not happen as the Minister said in 2005. Is it not the case that the HSE is now rapidly creating phantom primary care teams? Where GPs expressed an interest in primary care teams, this is now construed as being active participation and is meaningless.

Not alone has the failure of the Government to keep its promise to fund primary care to the tune of €1.1 billion as promised by the Minister's predecessor, Deputy Martin, been extremely damaging, but because it was in the pipeline it stymied many developments that might otherwise have taken place in general practice, some of which are now starting to come on stream as people realise that the funding will not be provided and these developments will not take place so people need to look to themselves to try to make things better. The situation has got so bad that this morning Senator Liam Twomey issued a statement pointing out that a GP cannot even get a blood test carried out for an elderly lady. If he is to repeat that, the laboratory still cannot guarantee it will be able to do the test because it has not got the resources. How is that for resourcing of primary health care?

As the Minister pointed out, the funding as originally envisaged will not happen and there is no identifiable strategy to allow any of these developments to take place. This is key. Does the Minister agree that it is the HSE's view, through Professor Drumm, that primary care should take a much more active role? How is that to happen in the absence of funding? It is all the more laughable to talk of reducing bed numbers and not delivering the 3,000 promised. The Minister mentioned co-location, which clearly will not work. I understand why the banks are nervous. The future of the NTPF under a change of Government will have to be reviewed. That should be borne in mind. Is the primary health care strategy dead? What specific funding has the Minister made available? She mentioned the past two years; the funding has been abysmal.

Charlie O'Connor (Dublin South West, Fianna Fail)
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Deputy Reilly should leave a little time for the reply.

James Reilly (Dublin North, Fine Gael)
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I shall. Would the Minister like to hazard a guess at how long it will take to roll out the primary health care strategy if she continues with the level of funding she gave last year and the year before?

Mary Harney (Dublin Mid West, Progressive Democrats)
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If Deputy Reilly was in my job, the economy would have gone under a long time ago because he thinks we should treble and multiply funding, representing, as he does, every vested interest that arises in health care.

Charlie O'Connor (Dublin South West, Fianna Fail)
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The Minister without interruption.

James Reilly (Dublin North, Fine Gael)
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If the Minister made any sense I would not interrupt, but that outlandish statement was laughable.

Mary Harney (Dublin Mid West, Progressive Democrats)
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There is huge investment in public health services, as Deputy Reilly well knows. It is not all a question of additionality, but of switching activity from the acute to the primary care setting.

James Reilly (Dublin North, Fine Gael)
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The Minister will not even fund the training places for GPs.

Mary Harney (Dublin Mid West, Progressive Democrats)
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Some GPs cannot get a GMS practice.

James Reilly (Dublin North, Fine Gael)
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That is a separate issue.

Mary Harney (Dublin Mid West, Progressive Democrats)
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I hope Deputy Reilly does not stand over that. It would not make sense training more GPs if they cannot get access to the GMS.

James Reilly (Dublin North, Fine Gael)
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Absolutely. It should be opened up.

Mary Harney (Dublin Mid West, Progressive Democrats)
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I am delighted to hear that and Deputy Reilly might use his influence on others.

James Reilly (Dublin North, Fine Gael)
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It should be opened up to well-trained GPs.

Mary Harney (Dublin Mid West, Progressive Democrats)
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Deputy Reilly negotiated a restriction on that on behalf of his profession.

James Reilly (Dublin North, Fine Gael)
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I did not. I fought to retain it.

Mary Harney (Dublin Mid West, Progressive Democrats)
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I am very surprised to hear Fine Gael would close down the National Treatment Purchase Fund that has very successfully treated more than 100,000 patients. A Fine Gael Deputy here for the vote, Deputy Sheehan, asked me about somebody needing a hip replacement in west Cork and when I told him about the treatment purchase fund, he said he would be very delighted to get some information to tell his constituent.

James Reilly (Dublin North, Fine Gael)
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How many did the NTPF treat in November and December? The money ran out.

Mary Harney (Dublin Mid West, Progressive Democrats)
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The treatment purchase fund has been highly successful and I am amazed Fine Gael plans to close it down. Many people would be surprised at that.

Some 630 staff have been assigned to primary care teams and I had the opportunity to visit one of them in Castleisland last Friday. It is not just about additionality but about how people work together and how the existing resource of public health nurses, physiotherapists, occupational therapists and GPs work in a community. In the first instance, we want to get them to work as a team because they deal with the same patients. We need better facilities. The HSE recently sought expressions of interest on more than 100 sites around the country and there were 400 expressions of interest. The first 18 contracts will be entered into very quickly and I welcome that level of interest from GPs and others around the country to provide the physical infrastructure so teams can operate effectively in a single centre.

James Reilly (Dublin North, Fine Gael)
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That is hardly an accolade. May I ask a supplementary question?

Charlie O'Connor (Dublin South West, Fianna Fail)
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No.

James Reilly (Dublin North, Fine Gael)
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Some 4,136 children are waiting on average 18 months for speech and language services, 4,062 children in the HSE for Dublin north east await orthodontic treatment and 3,596 children await psychological assessment countrywide, a third of whom have waited longer than 12 months. There are enormously long waiting lists for occupational and physical therapy and home help. There is the primary care strategy. That is the reality for people. It is another myth.

Charlie O'Connor (Dublin South West, Fianna Fail)
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Deputy Reilly has made his point and I must stick to the Standing Orders so I apologise.