Paddy Burke (Fine Gael)
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I welcome the Minister of State, Deputy Brian Lenihan, to the House.

Timmy Dooley (Fianna Fail)
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I thank the Minister of State for attending today to respond to this matter. He will know from the matter submitted that it relates to the extension of the co-operative service to the east Clare area. I know that the Minister of State is familiar with the county, including the eastern part.

The co-operative service is a major component of the primary health care strategy produced by the Department of Health and Children. As it stands, the lower Lough Derg region in County Clare is the only area in the county to which the co-operative programme has not yet been rolled out. It is known in County Clare as Shannondoc and is working very successfully in the north and west of the county and in the Ennis region. Parts of east Clare are very rural and quite a distance from any towns or villages where people live. Obviously, the service would be of immense benefit. The area stretches from Whitegate through Mountshannon, Scariff, Killenena, Feakle, Flagmount and so on down to Ogonelloe and across to Killaloe. It also takes in an area in Bridgetown and around Broadford, heading towards the Limerick border. The central region referred to as part of the Mid-Western Health Board region also takes in a small part of County Limerick on the eastern side and also part of north Tipperary from Ballina out to Newport.

It is critical that we get this moving. I know that the doctors of the region have come together. They are prepared to work and have a plan in place. I understand all that is required is Department sanction. In many cases throughout the country there is difficulty in finding personnel and in getting doctors to agree on the strategy for the out-of-hours service. That is not an issue in this matter. My understanding is that the programme will be ready for launch in about four weeks if the Department can approve it, provide the money and look after the technical aspects.

I ask the Minister of State to give due consideration to the request. The service would be of immense benefit and ensure that the people who live in that diversely populated area have the comfort of knowing that medical personnel are on call. The region is also important in terms of tourism and while the population is quite spread out during the winter, there is a concentration of population, with all the difficulties that can entail, particularly associated with Lough Derg. It is important that the service be put in place as soon as possible.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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I thank Senator Dooley for raising this matter on the Adjournment. It is a very important matter in County Clare and in what is now the Mid-Western Health Board functional area.

One of the key objectives of the Government has been to promote, develop and provide an effective and efficient system of general practitioner out-of-hours co-operatives. This has been an important development in improving the working conditions of the general practitioner and the delivery of service to the patient.

There are out-of-hours co-operatives in all health board areas at present, the majority of which provide full out-of-hours cover. The level of patient satisfaction with the service being offered by the co-operatives is very high both from the patient and provider perspectives and the development of such co-operatives plays a central role in the Government's primary care strategy.

The Department of Health and Children has provided €46.5 million to health boards and the Eastern Regional Health Authority between 2000 and 2003 for the expansion of out-of-hours co-operatives. In 2004, in excess of €26 million was allocated into baseline funding, bringing the total to in excess of approximately €70 million by the end of 2004. This figure does not include the fees paid to the participating general practitioners.

A very good example of a successful implementation of such a co-operative can be seen in the Shannondoc service which has been operating in the former Mid-Western Health Board's area. Since its inception as the Department of Health and Children, the Department has provided over €7.827 million in funding to Shannondoc. The first cell of the co-operatives started in the mid-west in May 2002 in Clare. The co-operatives was extended to cover Tipperary north on 15 October 2002. The co-operatives in the Mid-Western Health Board now involves 110 GPs working on a special consultation-type payment basis, providing services in parts of counties Limerick, Clare and Tipperary.

Submissions have been received, and a meeting has been held with officials from the Mid-Western Health Board with regard to the funding required to expand to this and other areas of the region. Decisions on the geographical areas to be covered by co-operatives and the order in which development occurs are matters for the relevant health board, which must have regard to the range of financial and other issues involved. Further expansion will be considered in the context of service requirements, health board proposals and funding availability. I should point out that my Department has requests for funding for co-operative expansion from several health board areas.