Frank Feighan (Roscommon-South Leitrim, Fine Gael)
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This is a very serious issue. The transfer of services from HSE offices throughout the country, including Roscommon and Leitrim will have an impact on local HSE services and staff.

The drugs payment, hardship medication, long-term illness and dental treatment schemes and the blind welfare and mobility allowances will be processed in the primary care reimbursement services offices in Dublin. We are all well aware of the confusion and disarray caused by the transfer of the over 70s GMS cards to these offices.

Decentralisation worked very well in this case. I cannot believe the Minister is undermining an excellent service and a source of employment in provincial towns. The staff of these offices are critically aware of the needs of the people in their counties. I am sick and tired of telephoning centralised Departments, being asked to press buttons 1, 2 and 3 and having to listen to songs on the telephone, which I do not have time for. Sometimes one's call is not even answered by these offices. A colleague of mine complained to me today about this very situation. The staff in centralised offices have no affinity with local areas and are far too busy.

Offices should be situated in the counties and constituencies they serve. I would like to hear the Minister's response on this matter.

Billy Kelleher (Cork North Central, Fianna Fail)
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I will be taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney.

The administration of the GMS scheme and the other primary care schemes is a matter for the Health Service Executive but I will answer Deputy Feighan with as much detail as possible.

The HSE has embarked on a major programme to transform health service delivery. In the recent past various reports have clearly pointed to a lack of clarity in relation to roles, responsibilities and accountability in the delivery of the primary care schemes, including the drug payment scheme, long term illness scheme, dental treatment services scheme, blind welfare allowance, mobility allowance and others.

These reports have in particular highlighted the following: the need for standardisation, streamlining and rationalising organisation arrangements; the need to integrate all local scheme systems with an national scheme index; duplication of effort and siloing of expertise across the country; and data integrity issues leading to incorrect payments to GPs. The Committee of Public Accounts has also considered these matters in some detail.

In this context, the HSE has decided that these issues could be best addressed if all of the primary care schemes were operated centrally. Up to the start of this year, primary care schemes were processed in the 32 local health areas. However, under the HSE's 2009 service plan, the administration of these schemes will be centralised and will transfer to the executive's primary care reimbursement service, PCRS, in Dublin. Local health offices continue to provide local assistance and advice to the public as normal.

The effect of this decision is that approval, review and reimbursement of all claims for services and refunds, under all of the primary care schemes will be under central governance through the primary care reimbursement service, PCRS. The change is being implemented on a phased basis. This phased implementation will allow the HSE to continually monitor the situation and if required, modify it to address any issues arising.

The decision by the HSE to centralise the administration of these schemes has been made in the context of the requirement to realise savings in this very challenging economic environment. The change will provide an enhanced standardised service to the client population. It will deliver services for the public within sustainable levels of expenditure and with the aim of achieving efficiencies by the greater usage of shared services. The proposed changes are intended to address the concerns set out above and enhance service delivery to the client. There will be no impact on patient care or the quality of service provided and there will be no effect on the assessment of people whose income exceeds the guidelines but have a case to be considered on medical or hardship grounds, as is the norm at present. Since all applications, reviews and associated tasks will be processed centrally, this will result in a more consistent and transparent approach being applied and will not have an adverse impact on patient care or the quality of service provided.

The HSE has advised the Department of Health and Children that there are no plans to close any of the local health offices and these offices will continue to deal with queries of a general nature about the GMS and primary care schemes and will provide any assistance needed with the administration process and, along with the HSE's national helpline, will deal with inquiries from clients in respect of their entitlements and completion of forms. However, the process will involve a reassignment of existing human resources within the HSE.

This is a good example of the type of innovation signalled in the transforming public services programme announced by the Taoiseach last November. It demonstrates how improved services can be delivered within the more limited resources available in a way which meets the needs of citizens in a modern society.

I fully support the HSE's decision to centralise these administration processes to one location as the HSE has advised that when fully implemented the measure will ensure the following — improved turnaround time for the processing of applications; equitable application of eligibility across the country; consistency of service provision to customers; clearer lines of governance and accountability; and improved unified data.