John Moloney (Laois-Offaly, Fianna Fail)

I thank Senator Bradford for his comments and Senator Ó Brolcháin for supporting him. I acknowledge that I am not a Minister of State at the Department of Finance; nonetheless, I fully support the Senator's proposal. Given my position in the Department of Health and Children, I know the reform of mental health services will be based on ensuring we remove the stigma attached to mental health and that the concept will be to use primary care centres as the locations for community mental health teams. In that context, we talked initially about having 200 primary care centres throughout the country, of which 100 initially would house community mental health teams. There would be two advantages to this. First, as I said, it would remove the stigma attached to mental health and, second, it could save in the region of €150 million on the original figure proposed four years ago. I fully support this proposal. Many talk about the need to incentivise to ensure GPs and medical practitioners not just to embrace the concept but to become totally involved with it.

I thank Senator Bradford for raising the issue, as it provides me with an opportunity to reaffirm the Government's commitment to developing community-based services at local level. The Health Act 2004 provides the Health Service Executive with responsibility for the management and delivery of health and personal social services. In line with the Government strategy, Primary Care — A New Direction, the HSE is refocusing its services to give people direct access in the community to multidisciplinary teams, including GPs, nurses, health care assistants, home helps, physiotherapists and occupational therapists. This is designed to maintain people in their own homes and communities for as long as possible, decrease hospital attendances and facilitate early hospital discharge and supported care at home.

The HSE plans to have 530 primary care teams and 134 primary care and social networks developed by 2011. Additional funding of €52 million in total has been provided for the HSE since 2002 for the development of primary care teams. At the end of 2009, 222 teams were operating, which is defined as holding clinical team meetings on individual client cases and involving GPs and HSE staff. A further 31 teams were holding clinical team meetings among HSE staff but without GP participation. Up to the end of 2009, almost 2,800 HSE allied health professionals, including 600 new frontline professionals, had been assigned to primary care teams and were providing services. Some 1,500 of these professionals are working in teams which are holding clinical team meetings and some 755 GPs are involved in the operation or development of teams.

As well as reassigning staff from primary, community and continuing care services to work in primary care teams, the HSE also intends to redeploy into community services a significant number of staff from acute hospitals and corporate functions. Where possible, primary care teams are based in a single facility to provide easy access for patients and enhance multidisciplinary teamwork. However, teams are working very effectively where they are not co-located. Although they are not in one single building, they still come together to have clinical team meetings. Use of IT facilitates team-working among team members who may be based in separate locations.

The Government, as part of budget 2009, announced its strong support for the HSE's innovative proposal to fast-track the roll-out of new primary care teams in collaboration with the private sector through leasing arrangements. In a report published on 10 February the Joint Committee on Health and Children set out a menu of possible incentives and supports that could be used to facilitate investment in primary care centres. Tax-based incentives are a matter for the Minister for Finance in the first instance in designing the annual Finance Bill for Government and Oireachtas approval. The Ministers for Health and Children and Finance will have their respective Departments assess the recommendations of the joint committee. The matter will be considered in the context of the Government's strong backing for the development of primary health care services and the best available means to support them.