John Curran (Dublin Mid West, Fianna Fail)
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I raise this issue out of sheer frustration. I was not a Member of the Thirty-first Dáil and was absent between 2011 and 2016 but the provision of primary care centres in the greater Clondalkin and Lucan areas has persisted in demonstrating a lack of progress. We are all agreed on the significance of primary care centres and, in response to various replies I have received, I understand the type of services they offer to communities such as nursing, counselling physiotherapy, social work, occupational therapy, speech and language therapy, dieticians, chiropody, podiatry and so forth. In addition to treatment, there is also health education and health awareness, which reduce the burden on acute hospitals.

I am at a loss to understand why little or no progress has been made on three specific cases. The first is in Rowlagh, north Clondalkin. A reply to Deputy Micheál Martin in February 2013 states:

Rowlagh / North Clondalkin was one of the 35 primary care centres announced under the infrastructure stimulus package in July 2012. Approximately 20 will be offered ... The preparatory work for the primary care centre project which precedes signing of any PPP agreements is well underway. While it is not possible, at this time, to give start and completion dates for any of the individual 20 potential locations, the best estimate is that these primary care centres will be completed by late 2016.

As time went on and nothing was progressing, I pursued the issue with other questions. At the end of last year I was told it was intended to lodge planning permission in early 2016. This summer the response was that the HSE was finalising the development of the primary care centre with the Department of Education and Skills and that the agreement between the HSE and the Department of Education and Skills was subject to planning permission being granted for the development. Furthermore, the HSE had engaged a design team which had completed the preliminary design. As it stands today, there is no application for planning. Considering the fact that the Department of Education and Skills and the HSE are agencies of the State, it is appalling that since the announcement in 2012 so little progress has been made. A site is available, there is a clearly identified need but there has been no progress.

The first project is the worst case because the State has control over all elements. There are two further cases, however. One is in Clondalkin village in regard to which the reply to a question of mine was that the developer had advised the HSE that it intended to sell his interest as he was not in a position to complete the development. The HSE has consented to the sale, subject to the terms and conditions of the original agreement being met, while the developer is currently disposing of his interest in the site and it is currently on the market. When the sale of the site is concluded, the HSE will engage with new owners to establish a timeframe for the completion of the primary care centre development. Again, the HSE is sitting around passively and it may take a very long time, in the current climate, to dispose of it.

The third case is in Lucan. I was told that the proposed development of a primary care centre was via an operational lease. An Bord Pleanála refused permission for the lease and the preferred developer has been withdrawn. I was told that the HSE intended to explore options for the delivery of a primary care centre for Lucan. My concern for this and the Clondalkin project is that they were under a lease agreement, in partnership with developers, and the HSE is not being proactive with them in looking for a solution. It states that it intends to explore options but this work should be actively pursued. It is now six months since planning permission was refused by An Bord Pleanála.

I know this is not the Minister of State's area of responsibility but I have brought it to the floor of the House because, having pursued this with parliamentary question after parliamentary question, the wording of the response has been good but the action terrible in respect of all three cases.

Catherine Byrne (Dublin South Central, Fine Gael)
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On behalf of the Minister, Deputy Harris, I thank Deputy Curran for raising this issue.

The Programme for a Partnership Government commits to a decisive shift towards primary care so that we can provide better care close to home for communities around the country. Primary care centres are an integral part of this because of the range of multi-disciplinary services they can provide and the role they can play in keeping people who do not need to be in an acute setting out of hospital.

I can advise the Deputy that 93 primary care centres, PCCs, are already operational, of which 50 were opened from 2011 to date in 2016. At present, there are 48 locations where primary care infrastructure is under construction or at an advanced planning stage, under three different methods of delivery, namely, 14 by direct build, 14 by public private partnership and 20 by operational lease.

The mechanism and timescale for delivery of primary care centres is dependent on a number of factors, some of which are outside the control of the HSE. Delivery of primary care infrastructure is a dynamic process, constantly evolving to take account of changing circumstances, including the feasibility of implementation. Regardless of delivery mechanism, all potential primary care infrastructure is subject to suitable locations being offered or provided or available, subject to successful planning processes and GP commitment to sharing accommodation and delivering health care services with HSE staff. In addition, the operational lease mechanism is subject to market pressures such as the developers' access to adequate financing. Some of these factors are outside the control of the Health Service Executive.

In Clondalkin, primary care services are provided from three health centres, Boot Road, Rowlagh and Deansrath. In Lucan, primary care services are provided from two health centres, Lucan village and Rosse Court. The planning permission for the proposed PCC in Lucan, which was to be delivered by the operational lease mechanism, was rejected on appeal by An Bord Pleanála. As a result, the HSE has withdrawn the agreement for lease and is currently investigating alternative options for the provision of a PCC in the area.

The HSE's Boot Road health centre site in Clondalkin was identified for redevelopment as a PCC. However, following planning process delays and the preparation of detailed design and tender documents, the developer, who also owns an adjoining site, was unable to source the required finance to develop the entire site, as intended. A number of interested parties have contacted the HSE in regard to the development of a PCC for Clondalkin and I am confident that agreement to provide a new PCC in the area will be achieved.

The HSE will ensure that the services currently being delivered from the Boot Road health centre will continue to be delivered in the area until a new PCC is developed. Purchase agreement for the planned PCC for Rowlagh and north Clondalkin, which is to be provided by direct build, is subject to planning permission being granted for the development.

John Curran (Dublin Mid West, Fianna Fail)
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I do not wish to be disrespectful but I am aware of most of what the Minister of State said. She said she was confident but, having gone through the process for so long, I have a complete lack of confidence in it. I want to pick her up on one thing. The Taoiseach, in his speech to this House yesterday, said, "Funding has also been provided to increase the number of doctor training places, and to deliver on the 80 additional primary care centres around the country." There are not 80 in the plans for the moment. The Minister of State said 93 were opened between 2011 and 2016 and she is correct but the response I received to a parliamentary question is really interesting because it shows that the momentum for primary care centres has been lost as the economy is recovering, for whatever reason. In 2012, 18 were opened while in the following year, 2013, nine were opened. In 2014, seven were opened and in 2015 five were opened while, to date in 2016, three have been opened. The words are fine but there is no momentum in the project and we are not seeing delivery. The Minister said services were being operated in various locations and she is right but they are not the comprehensive range of services, such as speech and language services, occupational therapy and so forth, that we would have in a proper designated primary care centre. That is the difference and I think the Minister knows that.

These three projects have been around the block numerous times. One of them is in the full control of various arms of the State via the Department of Education and Skills and the HSE. There is a need for more urgency. The other two, which require third-party intervention because they involve lease agreements or public private partnership arrangements, have stumbled. One of them is dead in the water because An Bord Pleanála has refused it. The Department needs to be much more proactive.

There was a time when if a Deputy asked a question on primary care centres, the answer was provided by the Minister. If one asks a question in that regard now, the Minister refers it to the HSE for reply. Primary care centres, in terms of the impact they could have on acute hospital services in our communities, are not delivering in the areas of speech and language, occupational therapy and so on. All of these services are missing. There is a need for greater urgency. I reiterate that only three centres will be delivered this year. Five were delivered last year. This process has ground to a halt in the past number of years and I do not know the reason for this. This issue must be addressed. I appreciate that the Minister of State, Deputy Catherine Byrne, is not the line Minister with responsibility in this regard.

Catherine Byrne (Dublin South Central, Fine Gael)
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Deputy Curran is more familiar with this area than I am. I know he is frustrated but I am unable to provide any more information. However, I assure the Deputy, as I did Deputy Harty, that I will raise this issue with the Minister on his return. What is important for me is that people get a proper service. Like Deputy Curran, I work with people in areas where primary care centres are important. They make a huge difference in communities in terms of the services they provide.

I agree with Deputy Curran that we need to be more proactive. For my part, I will nail the Minister down on this issue, following which I will get back to the Deputy on it.

John Curran (Dublin Mid West, Fianna Fail)
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I appreciate that.