Dáil debates

Tuesday, 27 March 2012

Priority Questions

Primary Care Centres

2:00 pm

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Independent)
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Question 5: To ask the Minister for Health the steps he will take to ensure that the proposed Wicklow Primary Care Centre, which was due to go into construction in April, is built and opened as scheduled, and that any shortfall in funding will be provided or guaranteed by the Health Service Executive [16865/12]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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I thank the Deputy for his question. The development of primary care, as the Minister of State, Deputy Shortall, has said, is central to the Government's objective to deliver a high quality, integrated and cost-effective health system. The programme for Government states that primary care will be an immediate priority area. The development of primary care centres, through a combination of public and private investment, will facilitate the delivery of multidisciplinary primary care and represents a tangible refocusing of the health service to deliver care in the most appropriate and lowest cost setting.

The HSE's draft plan for 2012 to 2016 is under consideration by my Department. It includes some provision for primary care, but further work is required to ensure that the provisions in the plan for a mix of private and Exchequer-funded primary care centres are in line with the programme for Government commitments.

Wicklow town is one of the locations where the Health Service Executive proposes to deliver a primary care centre through a leasing arrangement with the private sector. The executive has signed an agreement with a developer to lease part of this development once it is completed. I acknowledge the work that all parties, including GPs, have contributed to the progress on this centre to date. As the Deputy is aware, under public financial procedures the Health Service Executive is precluded from guaranteeing third parties as this may be interpreted as imposing a contingent liability on the Exchequer. However, the HSE has agreed to allow the developers a three-month extension to the agreement to lease, which was due to expire shortly. Extensions of this nature are granted only where progress and commitment have been demonstrated, which, thankfully, is the case here. I urge the parties to continue with their negotiations to expedite the completion of this centre.

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Independent)
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I warmly welcome the extension from the HSE, which is greatly appreciated and will buy some much needed breathing space. The centre in Wicklow town seems to represent best practice. It is a public-private partnership. It brings in multidisciplinary teams and high-end diagnostics, and in time there may be a nursing home there. It will create an additional 50 to 60 jobs. I believe some 50 or 60 existing jobs will be moved. The health care benefit for the region is enormous. As the Minister and two Ministers of State will know, Wicklow is one of the most poorly served counties across a wide range of services, including mental health services, acute coverage and palliative care. The issue is that if the extension is not fixed in the next 12 weeks this development will be lost because of an amount of €271,000. I accept that it is speculation on my part but this appears to be the case. I met the Wicklow Town and District Chamber and I spoke to the developer yesterday. It seems the bank is trying to get out of lending the money. The gap was €700,000. The developer has said the general practitioners have agreed to purchase their areas. That brings the amount to €300,000. The bank indicated that it did not count that amount as part of the €700,000 and that it intended to lend the project less money. Indications that the bank is trying to find any excuse to exit are written all over this project. It must not be allowed to fail for €231,000. The planning levy from Wicklow County Council is €543,000. Potentially, we will lose a remarkably important centre from a health care and an economic perspective over an amount only half of what the county council seeks for permission to build.

I accept the Minister's point about the HSE not being able to extend it. However, will the Minister and his officials explore with the council any and all options, including equity in property or whatever it takes, to ensure that an amount of €271,000 does not stop this critical facility from proceeding?

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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This centre or a centre for Wicklow town is critical indeed. We have no wish for a centre that is at an advanced stage to fail. I accept what the Deputy across the Chamber is saying in terms of banks not lending and the difficulties therein. We are looking outside the box at various methods of how we might fund the primary care centres we require throughout the State. We need a large number of them. However, I am of the same mind as my colleague, the Minister of State, Deputy Shortall. She is equally concerned about not only buildings but about services being available. This is why the emphasis on the previous question related to revenue for the employment of staff to provide services and care. That is in no way to suggest that we are resiling from investing in a capital programme or from making capital available to GPs to invest or from the State investing in primary care centres where they are clearly not commercially viable. However, where they are commercially viable we seek partners and interests from outside in respect of funds we can make available or joint partnerships to develop the range of primary care centres we need.

Deputy Donnelly's point is well made. Aside from the excellent new services and care they will bring and aside from the fact that they will take considerable pressure off hospitals, they will provide real employment in their areas. That is a factor as well.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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Are you happy enough Deputy?

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Independent)
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I accept the Minister's point that he will seek alternative funding options for the roll-out of the primary care strategies in principle. However, my question is specific to Wicklow town. Given the Minister's extension, only three months or 12 or 13 weeks remain. Will the Minister and his officials undertake to explore alternative options to bridge the €271,000 shortfall specifically for the Wicklow town primary care centre as a matter of urgency?

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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We will always explore all options. That is part of the job of the HSE estates management. Its job is to examine all options. I have no problem giving an undertaking that all options will be examined. Obviously, until they are examined we will not give an undertaking that they will be agreed to.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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I have a request from Deputy Kelleher to put back his Question No. 6 until after Deputy Ó Caoláin's question if the Minister, Deputy Ó Caoláin and the House are satisfied. Is that agreed to? Agreed.