Éamon Ó Cuív (Galway West, Fianna Fail)
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A Leas-Cheann Comhairle, ba mhaith liom buíochas a ghlacadh leis an Aire Stáit as teacht ar maidin ach caithfidh mé a rá anseo ar thaifead an Tí go raibh orm cur ina luí ar oifig an Chinn Comhairle maidir le Buan-Ordú 31 i ndáil le hAire as an réimse a fháil. I thank the Minister of State for coming in here today. I put it on the record of the House, however, that I had to invoke Standing Order 37 to ensure that a Minister or Minister of State from the Department of Health came in to take this question today. I think it should be routine that a Minister or Minister of State from the relevant Department would come in to take Topical Issue matters, which is happening less and less. Standing Order 37 is quite clear. It provides that if a Minister or Minister of State cannot come into the House on the day in question, then he or she must come into the House the following day. This is black and white. I wish to put this point on the record.

As the Leas-Cheann Comhairle knows, west and north Connemara is a vast area, stretching out to the west of Maam Cross and north to south from Carna and Roundstone up to Leenane and Cong on the other side. It is a vast area of indented coast and mountains, with a spread-out population and two offshore islands served from there as well, Inishbofin and Inishturk. The doctor from Clifden serves Inishturk in County Mayo too. The proposal for primary care centres in Connemara is that there would be one in Oughterard, one in Moycullen and one in Spiddal. These areas are all in the east end of Connemara. Níl aon cheann molta don Cheathrú Rua and there is no primary care there, but I will come back to this another day. None is proposed for Clifden.

Oughterard is the nearest proposed primary care centre. It is over an hour's travel away. Can the Minister of State imagine if people in County Cork were told they had to travel over an hour on bad roads to get to a primary care centre? It is over an hour from Ballyconneely or Cleggan and over two hours for people travelling from the islands. It is also an area where public transport is very poor. Clifden district hospital used to have a wide range of services and has had an X-ray machine installed in it since the 2000s. There are also good mental health services in Clifden. We know the nursing home in Clifden and the hospital there are going to be amalgamated with a new CNU on the St. Anne's site. This will free up the Clifden hospital site for the provision of a primary care centre. I do not want, nor do I expect, the Minister of State in this Department to give me the usual HSE standard speak here today. It is time the Minister of State told us that the more dispersed populations are entitled to services.

It is also important to note that Clifden is 80 km from Galway. Parts of this region are over 100 km from Galway, not to mention the challenges faced by the islanders. In relation to Inishbofin, planning was obtained for a new health centre there in the 2000s, but it has never been built. Some 16 years later, we are still waiting for the promised health centre on Inishbofin. I also inquired about Renvyle health centre, which is totally inadequate for the modern practice of medicine. It needs refurbishment and upgrading but I was told it was not going to happen. Cornamona health centre is a newish one that was built in the 2000s. It is not used by the GP. I cannot understand why health services, such as speech therapists, occupational therapists, physical therapists, counselling services, etc., could not be provided from the Cornamona health centre.

I hope that I will get real answers from the Minister of State today and a clear statement that the ministerial intent is to direct that the areas with dispersed populations will be entitled to a service within a reasonable distance of their homes.

Colm Burke (Cork North Central, Fine Gael)
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I have only been in this position for the last two weeks. I think this is now my third week. I got notice that I had been asked to deal with this matter late yesterday evening. I have no difficulty coming into this House and dealing with any Topical Issue matter in relation to health. I know now that I might end up regretting saying this, but it is my responsibility to come in here to address a Topical Issue query raised by a Member. I will do everything possible to make myself available to deal with these questions.

I thank the Deputy for giving me the opportunity to update the House on the delivery of a primary care centre in Clifden and the upgrade of other HSE-owned health centres in west Connemara. An objective of the programme for Government is to deliver increased levels of integrated healthcare, with service delivery reoriented towards general practice, primary care and community-based services to enable a home first approach. Primary care centres play an essential role in the delivery of that objective and significant progress has been made in the delivery of such centres nationally. These centres support the delivery of integrated care by facilitating closer co-ordination and co-operation between health professionals across different disciplines. Primary care centres also provide a single point of access to health services and can serve as a resource for the community. There are currently 174 primary care centres operational with a further seven currently under construction. In addition, 44 primary care centres are at earlier stages of development, four are currently at the advanced planning stage, 34 at the early planning stage and six HSE-owned centres are being progressed through capital plan funding.

The delivery of a primary care centre in Inishbofin remains a priority for the HSE. This project has been delayed due to legal processes associated with the transfer of land from Galway County Council to the Department of Rural and Community Development and the subsequent transfer of a portion of that land from that Department to the HSE. The HSE has advised that the legal agents for Galway County Council are progressing with this matter as swiftly as possible. Until the legal processes associated with the transfer of lands to the Department of Rural and Community Development concludes, it is not possible to provide a definitive timeframe for the transfer of the site to the HSE or the development of Inishbofin primary care centre.

Health centres in the Galway region, including Renvyle, were upgraded and refurbished over the past three years and this work continues. The primary care centre in Moycullen opened in April 2023. Proposed centres for Oughterard and Spiddal are at expression of interest stage. Other locations in the Galway west network may be identified in the future. The Deputy may be aware the decision to grant planning permission for the new ambulance base in Recess was issued by Galway County Council on 28 March. The new base will have space for two ambulances. A proposed primary care centre in Clifden is under review. However, the HSE is exploring the possibility of repurposing and upgrading existing HSE facilities in Clifden to expand the current range of services delivered by the Clifden primary care team.

The development of new or refurbished healthcare facilities anywhere in the country cannot be seen in isolation or separately from the delivery of related health care services. Projects are approved by the hospital group and then approved by the relevant HSE directorate before being submitted by to the HSE national capital and property steering committee. Once approved by that committee, the project is eligible for prioritisation and inclusion into the capital plan, subject to the level of funding.

Éamon Ó Cuív (Galway West, Fianna Fail)
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We come to Clifden near the end. It gets four lines. I ask the Minister of State to go back and inquire of the HSE, through the Department, whether it is intended to develop Clifden District Hospital as a full primary care centre. I want a full primary care centre plus things like X-ray facilities and so on because of the distance from Galway and because the hospital is there already and has been paid for by the State. If I could get that much out of today I would be making some progress. There was planning permission for a health centre on Inishbofin. I often wonder what would have happened had it been built. For some reason the HSE decided the site was not suitable after getting planning permission and it went up on the airport site. I tell the HSE and the Government that it just is not acceptable that these things take 14 years. There was a compulsory purchase done on that site in favour of Galway County Council and I cannot for the life of me see how it has taken 14 years to sort out the Inishbofin site. It is absolutely ridiculous how long things are taking.

I have visited the Renvyle health centre. It is totally inadequate. It does not have the rooms. It does not have the physical space. I am someone who grew up in Dublin and then moved to the west. Imagine telling the people of the area of Dublin I grew up in that they had to go 60 km to get to a primary care centre. Of course, it is good enough for the people on the periphery. How are the people from the offshore islands meant to get as far as Uachtar Ard? There are reasonable services from Clifden. The journey can at least be made by taxi.

Catherine Connolly (Galway West, Independent)
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Táimid thar am. Gabh mo leithscéal.

Éamon Ó Cuív (Galway West, Fianna Fail)
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Tá a fhios agam, a Leas-Cheann Comhairle, ach tá a oiread spéise agat sa scéal seo agus atá agam féin, nach bhfuil?

Catherine Connolly (Galway West, Independent)
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Tá neart spéise agam ach táim faoi bhrú. Tá rud eile-----

Éamon Ó Cuív (Galway West, Fianna Fail)
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Beidh tú ag súil le freagra iontach, nach mbeidh?

Catherine Connolly (Galway West, Independent)
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Tá mé anseo mar dhuine neodrach.

Colm Burke (Cork North Central, Fine Gael)
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I thank the Deputy again for raising this issue. An objective of the programme for Government is to deliver increased levels of integrated healthcare, with service delivery reoriented towards general practice, primary care and community-based services to enable a home first approach in line with the Sláintecare goal of receiving the right care in the right place at the right time.

The delivery of a primary care centre in Inishbofin remains a priority for the HSE. This project has been delayed due to legal processes associated with the transfer of land from Galway County Council. Until these legal processes conclude, it is not possible to provide a definitive timeframe for the development of the Inishbofin centre. Can I just say-----

Éamon Ó Cuív (Galway West, Fianna Fail)
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What about Clifden? The main question is about Clifden.

Colm Burke (Cork North Central, Fine Gael)
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I will come back to the Deputy. I wanted to say that as someone coming from a legal background I understand this, but I accept 14 years is a long timeframe and it should not take that long. Work continues on the provision of health centres in the Galway region. The primary care in Moycullen opened in April 2023. Proposed-----

Éamon Ó Cuív (Galway West, Fianna Fail)
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Will the Minister of State skip that bit and come back to Clifden because Moycullen, Spiddal and Galway are all fine. It is about Clifden.

Colm Burke (Cork North Central, Fine Gael)
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The proposed centres for Oughterard and Spiddal are at expression of interest stage-----

Éamon Ó Cuív (Galway West, Fianna Fail)
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Yes, we know that.

Colm Burke (Cork North Central, Fine Gael)
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-----planning permission for the new ambulance base in Recess was recently issued. Other locations in the Galway west network may be identified in the future. The development of primary care centres is based on geographical location, population density, topography and existing facilities. In order to enhance capital investment, the Department of Health is currently developing a strategic health investment framework to ensure investments are evidenced-based, equitable and ensure Sláintecare reforms are achieved with the overall objective of having better health outcomes for the population of Ireland.

I will come back to the Deputy on the main issue he raised.

Éamon Ó Cuív (Galway West, Fianna Fail)
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On Clifden specifically, is the HSE going to repurpose the hospital as a primary care centre?

Colm Burke (Cork North Central, Fine Gael)
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I fully understand. If I may say, I have been involved in a number of projects that had different parties involved. In one case I had six different parties and every time I got on to one I was given the answer it was someone else's fault. Sometimes it gets frustrating, but I will follow it up for the Deputy.