Louise O'Reilly (Dublin Fingal West, Sinn Fein)
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I thank the Minister of State for being here to discuss the Topical Issue concerning the need for primary care services for my constituency of Dublin Fingal West which is, as I am sure the Minister of State is aware, one of the fastest growing constituencies in this State. We also have a very young profile; we do not necessarily fit with the profile of the rest of this State.

There is no hospital in my constituency to be fighting about but equally, there is a real, serious lack of primary care services. When the people in my constituency need to access the health service, they must leave. If they need a hospital or the services provided by a hospital, they must leave. They travel to Drogheda, to Beaumont, to James Connolly memorial hospital or the Mater but they must leave. They cannot get those services in our area. At least once a week on the social media forums such as Balbriggan Connected or Skerries Connected or in Rush, Lusk and the surrounding areas, somebody will post into the group asking if anyone knows of any GP who is either taking patients or taking patients with a medical card. There then begins a succession of replies advising people that no, there are no GPs in the area, or even if you have a GP in the area, you will wait for days and in some cases weeks to see the same GP.

The Government talks a lot about Sláintecare and has done precious little about it. I sat on the future of healthcare committee and I remember the lofty plans. It was adopted by almost every party in here but it falls to the Government to implement it and it has badly fallen short. Nowhere is that more evident than in my own constituency. We have a primary care centre in Balbriggan that was set up on the back of what was generally regarded not just by me but in the media as a political stroke. We wonder sometimes in north County Dublin if perhaps the origins of our primary care centre is the reason why it is so neglected. The HSE will say it is operating at full capacity but it has 27 vacancies waiting to be filled. It has also been confirmed to me that there are no immediate plans to develop phlebotomy, X-ray or diagnostic services in Balbriggan Primary Care Centre. If the Government is not going to put it into Balbriggan, which is the biggest population centre in my constituency, where is it going to put it? Alternatively, is the message to my constituents a simple one: they must wait and if they require simple services like an X-ray or diagnostics, they must travel outside the area? That is not good. It is not good for patients and it certainly is not good for my constituents. It makes a mockery of the commitments given under Sláintecare.

Some years ago, I submitted a box full of petition postcards to the former Minister for Health, Deputy Harris - I think I did the same when Stephen Donnelly was Minister for Health - requesting access to diagnostic services within my constituency. Rooms lie idle in a primary care centre while people are travelling miles to get simple services that should be available to them in their own community. In this day and age, with all the commitments the Government has given and all the fine words it has said regarding Sláintecare, it should not be too much to ask that we have proper primary care services within my constituency of Dublin Fingal West to serve people living in towns like Rush, Lusk, Skerries, Balbriggan, Oldtown and all across north County Dublin. As I said, the absence of these services means my constituents must travel miles for very simple, basic healthcare services.

Jerry Buttimer (Cork South-Central, Fine Gael)
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I first congratulate Deputy O'Reilly on her appointment as Chair of the petitions committee. I served on that committee for eight years and I wish her well because it is an extraordinarily important committee of the Houses.

I hear the Deputy's concerns and I thank her for raising the matter. As the former chair of the health committee, I understand fully the Deputy's articulation of the issues surrounding the provision of primary care and healthcare. The Minister for Health has asked me to convey to the Deputy her apologies for not being here, to thank the Deputy for raising these matters and for the opportunity to update the Dáil on the provision of primary care services in Fingal West and, in particular, Balbriggan Primary Care Centre. I have taken note of the comments the Deputy has made and I will bring them back.

The area of Fingal west is located in the integrated health area of Dublin north county and delivers a wide variety of integrated community and primary care services to meet the health needs of the local population. The health and social care services currently available in Balbriggan Primary Care Centre, PCC, include primary care therapy services and community specialist teams for older people, alongside a chronic disease hub.

Disability services located in Balbriggan PCC also include the children’s disability network team. There are two community mental health teams in the primary care centre which accommodates the second highest attended CAMHS clinic in 2024. In addition, several social inclusion services operate from Balbriggan PCC, including a social inclusion liaison officer, a Roma clinic and the north Fingal community development project. A central objective of the programme for Government is to deliver increased levels of integrated health and social care with service delivery re-oriented towards general practice, primary care and community-based services to enable a “home first” approach.

It is acknowledged – as the Deputy has rightly said - that the Balbriggan area has grown significantly in recent years, with the population increasing by 12% between 2016 and 2022. Among towns with more than 10,000 people, Balbriggan is the youngest town in Ireland with a diverse population. The Minister is committed to building capacity in primary care, as outlined in the programme for Government, by recruiting additional staff numbers, promoting advanced practice roles in the community for health and social care professionals and increasing the number of college training places for health and social care professions. The Minister for Health acknowledges there are challenges, particularly with local vacancies articulated by the Deputy in her comments here this afternoon, which are impacting the waiting times for access to services.

The establishment of the HSE’s six health regions means services can plan and deliver around the specific needs of people in each area. Each of the health regions has its own budget, leadership team and responsibility for local decision-making and continuing to work towards the Sláintecare objectives. Each of the six health regions and each national service has been provided with a specified number of whole-time equivalents in terms of staffing and can replace, recruit and prioritise staff within that approved number. This has provided the health regions with further control to focus resources where there is the greatest need and greater capacity for decision-making at a local level regarding prioritisation and filling of available posts.

As I said, I will take Deputy O’Reilly’s points back. I know some of the points she raised have not been addressed in the reply I have given and I accept that. I am here on behalf of the Minister, as the Deputy will understand but I will take the points she has made back to the Minister regarding idle spaces and the lack of delivery. She is right; there is a need to urgently expedite the whole issue of primary care in many of our emerging towns and the area she has mentioned is one.

Louise O'Reilly (Dublin Fingal West, Sinn Fein)
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What I heard was "you must wait, you must travel, you are not getting the services." I have been at this for nine years. We have a primary care centre and it is a white elephant or whatever that expression is. It is not being utilised to its greatest extent. There are empty rooms and diagnostic suites that should and could have facilities in them to ensure people did not have to get into their cars or call an ambulance and travel outside of my area to put pressure on hospitals in other areas that are already under immense pressure.

Balbriggan Primary Care Centre cannot even provide immunisation facilities for older people and children. There is a chronic waiting list for GPs in north County Dublin. It is acute in Balbriggan and yet every time I ask whether the Minister will look to directly employing GPs, even just to clear the backlog, the answer is stonewalled and silenced. The Minister of State mentioned the community specialist teams for older people, the children's disability network team and the community mental health teams but none of those are staffed; none of them are fully staffed. All those teams require recruitment. I reiterate that the HSE has told me in no uncertain terms that there are no immediate plans to develop phlebotomy, X-ray or diagnostic services in Balbriggan Primary Care Centre.

I ask, on behalf of the people of Balbriggan and the area surrounding it who will be able to utilise the Balbriggan Primary Care Centre, that the Government please include in its immediate plans phlebotomy, X-ray and diagnostic services for Balbriggan Primary Care Centre.

It is a fast-growing area. The demand is only going in one direction. I ask that at the very least the deficits be made up and some provision be made to future-proof it. The Minister of State mentioned Sláintecare but what is happening in Balbriggan and the areas served by Balbriggan Primary Care Centre is the very opposite of Sláintecare. It is telling people to get into their cars and travel for services.

Jerry Buttimer (Cork South-Central, Fine Gael)
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I understand the Deputy's frustration. Primary care and the utilisation of the centre are perhaps matters that the HSE is best placed to tackle. Equally, the local regional health forum is a forum where the Deputy and other public representatives can put pressure on the HSE. However, I take the Deputy's point. Again, on behalf of the Minister, I wish to reassure the Deputy and I thank her for raising this important issue.

The Government is as committed as the Minister is to the development of primary care and community healthcare services, as committed to in the programme for Government. To expand and develop community care services, recurring annual funding of €195 million has been provided to the enhanced community care, ECC, programme. This suite of strategic reform initiatives seeks to reduce dependency on the hospital system by delivering increased levels of healthcare provision in the community setting, with service delivery reorientated towards healthcare general practice, primary care and community based services, which is what the Deputy has articulated and is what we are committed to.

Since its launch in 2020, the ECC programme has significantly expanded, with more than 2,800 additional healthcare staff recruited and the successful establishment of 96 community health team networks and 53 of the planned 60 community specialist teams for older people and chronic disease. Aligned to the ECC programme, GP access to community diagnostics provides a direct referral pathway to GPs for patients to access community-based radiology scans, including X-rays, DXA, MRI and CT scans and chronic disease tests. This service has received significant funding of almost €47 million for its continuation this year, and will provide 240,000 community radiology scans and up to 161,000 chronic disease tests within the year.

The Government fully recognises the frustration in the local area, as articulated by the Deputy, in regard to waiting times and lack of availability of services. It also recognises that much work needs to be done to fill vacancies at local level and address waiting lists. To this end, a joint Department of Health and HSE programmatic approach to primary care waiting lists is under way to develop both short-term and long-term solutions to the long waiting lists for primary care services in order to ensure consistent, equitable and timely access to primary care services.