Michael McCarthy (Labour)
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I welcome the Minister of State, Deputy John Moloney.

Paul Bradford (Fine Gael)
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I also welcome the Minister of State. I believe, however, that my Adjournment Matter is more pertinent to the Department of Finance than the Department of Health and Children. My request is that the Department of Finance make a degree of financial provision by way of tax relief, etc, to support the introduction of primary care centres.

I seek permission to share time with Senator Ó Brolcháin.

Michael McCarthy (Labour)
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Is that agreed? Agreed.

Paul Bradford (Fine Gael)
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Wearing his hat as Minister of State at the Department of Health and Children, Deputy John Moloney, will be very much aware of the benefits which could flow to this country and every citizen if we were in a position to develop primary care centres. All the experts believe — it is shown by a significant body of research work — that perhaps up to 90% of regular health care services could be provided in such centres. This would transform the way medical services are supplied in this country, ensure the days when the hospital was seen as the only source of medical care would be long forgotten and that in all our large towns and many smaller ones we would have centres in which a significant amount of the care services required by every citizen would be provided.

The HSE, presumably in conjunction with the Minister of State's Department, has been working on this concept. There is a view at levels of the HSE that more than 200 such primary care centres should be developed. I am sure the Minister of State is aware that the Joint Committee on Health and Children has also been working on the issue. A report published recently by it is very supportive of the concept. My understanding is that while the HSE aspires to having over 200 such centres throughout the country, plans for approximately 100 such projects are being worked on and considered for construction. Therefore, questions of finance and incentives must now be considered. We have to recognise that in today's economic environment the construction of these centres would be a major financial burden on all concerned. I hope the Minister of State will be in a position to sit down with his colleagues in the Department of Finance to try to put in place some financial incentives to actually make these projects work. Some of the suggestions made to us and, more importantly, by our colleagues at the Joint Committee on Health and Children are that the Department of Finance consider measures such as capital tax allowances, double rent relief, double interest relief and so on. In other words, we are not seeking grant aid or money from the State, rather we are seeking incentives to allow projects to progress which would be controlled and managed by GPs. If we can get these development projects up and running, a huge number of people will be employed during the construction phase of these 100 to 200 centres. All of the key health care professionals will be involved in the development of the centres but, more importantly, we will bring world class health care services to almost every town and village and transform the way health care is provided.

I ask the Minister of State to continue to support the concept behind the projects within his Department. The key is providing some financial incentive. In the context of the Finance Bill, I hope the Minister of State can liaise with the Minister and the Department of Finance to try to kick-start the projects.

Niall Ó Brolcháin (Green Party)
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I welcome the Minister of State, Deputy John Moloney, and congratulate him on the various initiatives he is bringing forward. I very much support Senator Bradford in this regard. As I have walked and cycled throughout my constituency, I know it is 100 miles long. As we see centres of excellence developing at a high level and given that some local hospitals are closing, it is important we ensure provision of primary health care services to a very high standard locally in many parts of the country in order that people do not have to travel long distances for to undergo basic procedures.

The Government's policy is very welcome. I agree with Senator Bradford that it is time we got on with this development and pushed the provision of primary health care services in a big way. I commend the Minister of State for his efforts to date. I am delighted Senator Bradford asked me to take part in this debate because it is something we need to support across the parties. I note that health care is no longer as big an issue as it was in previous years. Real progress has been made by the Department of Health and Children and I hope we can make further progress.

I had the honour to represent Galway city at a World Health Organization conference in Finland which is now the top country in terms of health care, despite coming from a position similar to Ireland. Primary health care was one of the key factors which helped Finland to become the top country for health care services.

John Moloney (Laois-Offaly, Fianna Fail)
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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.

Paul Bradford (Fine Gael)
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I thank the Minister of State for informing me that the Ministers for Health and Children and Finance will have the recommendations of the joint committee assessed. I stress the need to ensure an early decision on the matter. There are dozens of projects which could get under way in the near future, providing a huge economic boost and, more importantly, a long-term health gain. If a decision is to be arrived at in a positive light, it should be made as soon as possible.

I understand the Finance Bill is working its way through the system and will be brought before this House when the debate concludes in the other House. There is strong all-party unity on the desirability of centres being put in place as soon as possible. However, we have to live in the real economic world and accept that some incentive is required. Those involved tell us they are not looking for cash grants or handouts but simply for some of the wide range of incentives put in place to facilitate developments in other sectors. Health is surely the most important sector in our society, affecting as it does every single family and citizen. The Minister of State has made major progress on mental health issues and is well placed to argue with his senior Minister and, more importantly, the Department of Finance to respond favourably to what is a very modest demand by those who wish to develop primary care centres.

I wish the Minister of State well in his endeavours. If we can succeed, we will in a short time transform the delivery of health care services to every citizen on the island. That should be our goal and it is very achievable. I look forward to the ongoing efforts of the Minister of State in the promotion of this concept.