Michael McGrath (Cork South Central, Fianna Fail)
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I welcome the opportunity to raise this important issue. There was a great welcome in 2001 when the new primary care strategy was unveiled. It set very ambitious targets in regard to the roll-out of primary care teams throughout the country. Indeed, the target set at the time was for over 500 primary care teams to be implemented and established throughout the length and breadth of the country. According to the HSE website today, there are 120 primary care teams up and running.

It is important to go back to the reason that the primary care strategy was introduced, namely, because it is estimated that 90% to 95% of the interaction that people need with their health service can be delivered at a local level, in the local community, in an environment that is more appropriate to their needs, more convenient and more accessible. We need to move away from the traditional system in Ireland of having a greater reliance than is necessary on the acute hospital system.

It is important that we implement the 2001 strategy with a greater degree of urgency. Progress thus far has been slow. While a certain number of primary care teams have been established, with excellent outcomes for the communities concerned and the patients they serve, there is potential for much greater progress throughout the State. In particular, I propose to highlight the situation in Cork county and city.

There is no doubt that our traditional system of patients accessing the acute system via GP referral is overly cumbersome and bureaucratic. People who do not need to enter an acute hospital environment are forced to go through the system, which can be slow and expensive. In many cases, patients' needs could be met at a local level if an appropriate primary care facility were available in their community. Primary care teams can provide a range of services, including GPs, practice nurses, community nursing services, occupational therapists, physiotherapists, social workers, home care and support staff and so on. In addition, primary care team members can link in with other community-based disciplines to ensure all the health and social needs of the community are provided for, including speech and language therapy, dieticians, mental health services, counsellors, psychologists, chiropodists, dentists and so on.

Last June I spoke in an Adjournment debate about the situation in my home town of Carrigaline where the Health Service Executive has acquired a suitable site to develop a primary care centre. Planning permission has been granted for a state-of-the-art facility and a budget of more than €4 million was allocated for this purpose in the executive's capital plan. However, the project continues to await sanction because of the review of that plan. This is symptomatic of what is happening with other projects throughout the State which have unfortunately been stalled because of budgetary issues.

The simple economic reality is that we will save money in the long term by investing now in primary care centres. An effective primary care network keeps people out of the bureaucratic and expensive acute hospital environment where the vast majority of them do not need to be. More people are likely to interface with the health service if services are available at a local level. That is far preferable to having to travel, once an appointment is eventually secured, to a busy acute hospital environment. It is a question of better outcomes for patients and better value for money for the taxpayer. It makes sense to provide the vast majority of health and social services at a local level where people can access them in a convenient manner and where they can hope to achieve the best possible outcome. I look forward to hearing the Minister of State's update on the roll-out of primary care centres in Cork city and county. Some progress has been made in this area but there is potential for much more if the political will is there.

Trevor Sargent (Dublin North, Green Party)
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I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. I thank the Deputy for raising this issue as it affords me an opportunity to reaffirm the Government's commitment to developing community-based services at local level.

The Health Act 2004 provides the Health Service Executive with responsibility for the management and delivery of health and personal social services. In line with the Government strategy, Primary Care - A New Direction, the executive is refocusing its services in order to provide people with direct access in the community to multidisciplinary teams including general practitioners, nurses, health care assistants, home helps, physiotherapists and occupational therapists. This is designed to maintain people in their own homes and communities for as long as possible, decrease hospital attendances and facilitate early hospital discharge and supported care at home.

The HSE plans to have 530 primary care teams in place by 2011. Of that number, almost 130 are already in place and it is intended to have 210 in place by the end of 2009. Of the planned overall total of 530, 138 of the teams will be in the HSE southern area, including 66 teams within Cork city and county. The HSE southern area's target is to have 63 primary care teams in operation, that is, holding clinical team meetings on individual client cases and involving GPs and HSE staff, by the end of 2009. As at 30 September, there were 39 teams in operation in the area. Of these, 13 are in operation in Cork city and county, serving a population of more than 90,000 persons. Another 20 primary care teams in Cork city and county are at various stages of development, with at least ten due to become operational by the end of this year.

The HSE is reassigning staff working in primary, community and continuing care services to work in primary care teams. The executive also intends to redeploy into community services a significant number of staff from acute hospitals and corporate functions. Where possible, primary care teams are based in a single facility to provide easy accessibility for patients and to enhance multidisciplinary teamwork. However, teams are working very effectively where they are not co-located. Although they are not in a single building, they still come together for clinical team meetings. Information technology usage facilitates team working among members who may be based in separate locations.

As part of budget 2009, the Government announced its strong support for the Health Service Executive's innovative proposal to fast-track the roll-out of new primary care centres in collaboration with the private sector through leasing arrangements. The HSE has indicated that, to date, its board has approved a total of 19 locations in Cork city and county to proceed with negotiations with interested parties to secure leasing arrangements. One agreement for lease has been signed and 14 letters of intent have issued.