Cormac Devlin (Dún Laoghaire, Fianna Fail)
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I welcome back my constituency colleague, Deputy Boyd Barrett, and wish him well in the rest of his recovery. I would like to raise the status of the long-promised primary healthcare centre for Loughlinstown and the surrounding communities. The HSE confirmed earlier this year that the operational lease process for the new Loughlinstown primary care centre collapsed when the preferred operator withdrew for viability reasons. The HSE advised it is now carrying out a service-led review before deciding on the next steps. I fully accept the HSE must ensure value for money and that projects are deliverable. However, it is vital this review does not quietly become a vehicle to move the primary care centre out of Loughlinstown and into Cherrywood or elsewhere.

Loughlinstown, Ballybrack and the wider area have some of the highest levels of disadvantage in my constituency. It is also an area with a significantly older population, with the Dún Laoghaire, Dalkey and Loughlinstown community healthcare network recording 20% of residents to be aged over 65 compared with 15% nationally. They are precisely the communities that most depend on accessible, local primary care. Cherrywood, by contrast, is a new strategic development zone built from a new urban centre with plans for more than 10,000 homes and a projected population of roughly 26,000 people, orientated towards younger working households, well served by the Luas and the new town centre facilities. Cherrywood, rightly, will need services of its own but they should be additional to, not a replacement for, the long-promised upgrade of the primary healthcare centre in Loughlinstown. There is already a HSE health centre and primary care team in Loughlinstown delivering valuable services on the ground today.

The purpose of this project is to modernise and expand those services on or adjacent to the existing site and not to relocate them elsewhere from people with the greatest need. I ask the Minister, on behalf of the Taoiseach, for whom he is taking questions today, to reaffirm the Government's commitment to delivering a new primary care centre in Loughlinstown, serving Loughlinstown, Ballybrack, Shankill, Shanganagh and the surrounding estates, and to confirm that the current HSE service-led plan will explicitly take into account the deprivation and age profile in deciding its location so we do not see a shift of resources from an older, lower income community to a more affluent, younger one.

Jack Chambers (Dublin West, Fianna Fail)
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I thank Deputy Devlin for raising this very important issue. It is one he has been consistently raising and campaigning for on behalf of all of his constituents.

Of course, the HSE and Department of Health should, in any instance, focus on deprivation and demographics when it comes to the positioning of capital investment in terms of its overall allocation. As I mentioned previously, over the next five years, there will be an overall capital budget of over €9 billion. I think we will see a significant acceleration of investment in primary and community care right across our country. All of that is to manage the broader risks we have on demographics, ensure we can treat more people in the community, anchor more primary healthcare workers and embed more healthcare professionals in the community. That is the work that is ongoing in terms of the regional health areas.

A central objective in the programme for Government is to deliver increased levels of integrated healthcare and that is towards general practice, primary care and having a home first approach, as I have referenced. Integral to this is the development of primary care centres across the country, in local communities such as Loughlinstown and in the Deputy's own community. They form a critical part of our healthcare infrastructure, providing a single point of access to primary and community care services for individuals. Progress has been made during the past number years. One hundred and eighty primary care centres have opened across the country and a further seven are under construction.

Related to the Deputy's specific question, the HSE has confirmed the proposed delivery mechanism for a primary care centre in the instance he referenced was through the HSE primary care operational lease model. A tender process was undertaken and a preferred operator was selected. The HSE further advised that, unfortunately, the selected preferred operator then encountered difficulties in relation to the economic viability of the proposed project, which resulted in the collapse of that process. The HSE has confirmed that a service-led review is under way and that is to validate some of the questions the Deputy referenced. He spoke to the importance of age demographics being critical to managing the broader trends we see in communities across our country. There is also deprivation and we know education and healthcare are critical to enabling opportunities for people and also to mitigating a lot of the risks of intergenerational poverty. That is why deprivation should be a critical focus in the wider deployment of this capital funding.

The HSE has confirmed a review is under way and HSE capital estates is looking at the best location for the primary care centre and then the most appropriate method of delivery for expedience, value for money and delivering for the local community.

Cormac Devlin (Dún Laoghaire, Fianna Fail)
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I thank the Minister for that reply and acknowledge what the HSE states about the regional health areas and the single point of access. However, this primary care centre is nearly a decade in the making. I understand it has planning permission, or did at one stage, and it beggars belief how long this has taken to redesign and redevelop the existing site where primary care is being administered at the moment. There is genuine concern locally that as Cherrywood continues to grow and attract investment, there will be pressure to rationalise, as was mentioned in the reply from the HSE, by shifting the new primary care centre there instead. It might look more efficient on a map or on a desktop but it ignores the original objective of that project that was conceived to serve an older and less well-off community. The demographics illustrate that, even in the HSE's original documentation.

I ask for a commitment from the HSE to meet local TDs prior to any finalisation of any review but it is also important to highlight-----

Verona Murphy (Wexford, Independent)
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Thank you, Deputy.

Cormac Devlin (Dún Laoghaire, Fianna Fail)
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Go raibh maith agat.

Jack Chambers (Dublin West, Fianna Fail)
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The HSE should continuously engage with local TDs representatives around healthcare needs and the feedback they are receiving from constituents and also on the critical point the Deputy made on demographics and deprivation playing a really important role. The Deputy mentioned the huge amount of construction in other parts of his constituency where we will see an inevitable rise in demand over time. That should be a factor in the HSE's overall consideration of how primary care centres are deployed. The HSE is conducting a review. It is unfortunate the process collapsed. I will ask the HSE to reflect on the feedback the Deputy has given and, in its engagement with local TDs, to reflect on the wider work we will do over the next five years as part of the capital investment programme.