Joe O'Toole (Independent)

I fully support the arguments for having primary care centres but does this not represent taxpayer investment in a private institution? Have I misread what my Fine Gael colleagues have put forward? Does this not involve putting public money into a private hospital or health care system? I agree completely with all the argumentation on both sides of the House, especially that of Senator Twomey at the beginning of the debate in respect of the importance of the local availability of primary care centres and diagnostic and other equipment. I fully support that sentiment.

I have had a difficulty for many years with the ability of highly paid consultants to use equipment in hospitals paid for by the taxpayer. Am I being unfair to the proposers if I interpret this measure as our putting money into a commercial operation for local GPs? I do not say as much in any demeaning way and in no way do I demean the quality of the service, but how do I explain to people who work in the Passport Office that we are now prepared to put money into what is a very lucrative enterprise for local GPs? I put that spin on the proposal for the moment which is somewhat unfair to them. I accept fully the point that their objectives would be to provide the best level of care, which is laudable and something we should support. I am prepared to support whatever it takes to make primary health care available in local areas. However, I am not convinced - perhaps I have not yet heard enough - about whether taxpayers' money should be put in to what will be, effectively, locations where local punters pay €75 to get checked out. Is there any payback for the taxpayer and patient? This is what I wish to establish. If we make this available will it mean some reduction for the people who walk in the door? We all agree on the point, made very firmly and clearly by colleagues on both sides of the House, that we should have primary health care and that the State should invest in it. That is my view but this is somewhat like co-location.

Perhaps I am being somewhat unfair and I look forward to hearing what Senator Twomey says in response. I understand the objectives, which are laudable. I appreciate the outcome would be very good in terms of local areas but will one of the outcomes result in a more lucrative operation for GPs? By the way, I have no objection to or difficulty with GPs being well paid and earning money. However, if that is the only net outcome and there is no payback to the patient, why should we put money into it? Perhaps that is somewhat unfair on Senator Twomey but I wish to know where we stand.