Tuesday, 2 February 2016
Primary Care Centres
Tá ábhar an-tábhachtach le hardú agam ar Thosú an tSeanaid inniu. I have a very important matter to raise in the Commencement debate. It goes to the heart of the failure of the Government's primary health care strategy. The Government has been slowly opening a number of primary health care centres throughout the country.Full and integrated primary health care is essential, not just for curing and treating people, but for solving the hospital crisis. Too many people are going to hospitals when they could easily be treated in primary health care centres.
I was pleased that pressure was applied in the Seanad by me and in the Dáil and locally by my colleagues to ensure that the centre in Kells was delivered. It has been built and is about to open, but a number of issues have arisen, one of which is that of parking charges. The centre is situated far outside the town and there is no issue with parking in the area except at the health care centre. The only reason one might go to the building is to attend the centre. One cannot nip out to the shops beside it because there are none.
It has been suggested locally that there will be a charge of €4 to enter or exit the car park. For someone driving from Kells town to the centre, €4 is a great deal of money. Is there a policy on this matter at national level? It makes doctors' practices unattractive, as parking can be found at considerably cheaper rates or for no cost at all in the town centre. The charge goes against the strategy and should not happen. I hope that the Minister of State will tell me that it will not happen. It is not right. There have been too many controversies about parking charges at hospitals and the inconvenience these pose. Generally speaking, hospitals are one-off events for most people whereas attending a primary care centre is a regular event, in particular for many people with chronic diseases. They attend centres to get appropriate treatments at an early stage in order to stay out of hospital. Why are parking charges being tolerated and will the Minister of State stop their imposition?
I have had a very busy day and I have never refused to attend the Seanad. I am always the most obliging. However, the notion that I am in here discussing something that the Senator thinks might happen when I should instead be in the Dáil dealing with something that is very serious is a different day.
The amount of car parking required for a primary care centre is determined by the size of the centre, the range of services it provides and its location. The development of these centres will facilitate the accommodation of a range of primary care centres, including general practitioner care, community health nursing services and physiotherapy, occupational therapy and speech and language therapy services. Dental, ophthalmology, podiatry and psychological services may be sited in these centres along with other integrated services, for example, mental health, child care development, disability, antenatal, etc. However, the amount of car parking provided at a particular primary care centre must comply with the car parking standards set out in the relevant local authority's development plan. Fianna Fáil is the largest party on this-----
In primary care centres developed on HSE-owned land, car parking is generally free of charge. In certain circumstances that are dependent on a centre's location, however, it may be necessary to control car parking and charge for its use. I am assuming that this is when a centre is in the middle of a busy and built-up area. In these circumstances, parking fees are similar to those charged by the local authority for parking in the area.
As the Senator will be aware, local authorities throughout the country operate systems of parking restrictions and fees so as to ensure that parking does not cause obstructions for other people using the roads and footpaths or accessing local businesses or services. In primary care centres delivered by way of operational leases, a specified number of spaces are provided to the HSE under those leases. Any additional parking provided by the developer is under his or her control and he or she may charge fees on these additional spaces. The parking fees charged by the developer are generally in line with the public car parking fees in the area.The modernisation of our primary care structure and practice is vital to the successful delivery of services in the future. The development of primary care teams and primary care centres is a priority under the programme for Government and an extremely important element in the health reform process. The provision of primary care centres and teams throughout the country will significantly increase health and social care in local communities, which will be achieved by redirecting services away from acute hospitals. Primary care infrastructure is being delivered under three mechanisms, namely, direct build, leasing initiative and public private partnerships, PPPs, announced in 2012. As for the slow roll-out - I hope the Senator takes note of this - the development of primary care centres is central to this Government's objective to deliver a high-quality, integrated and cost-effective health system. To date, 90 primary care centres have been completed and a further 16 are under construction. That is in the middle of the worst economic collapse this country has ever seen. In addition, it is expected that the PPP contract for the provision of 14 primary care centres will be signed this month, February 2016, and construction will commence next month. The notion that I am in here-----
I have never refused to come in here. I have always come in here and have been the most accessible Minister. The notion that I would be in here today, talking about what the Senator thinks might happen-----
If the Minister of State was needed in the Dáil, we would have accommodated that. The Leader said she was available at this time and we said that was fine. There was no discussion. It was due to be at 2.30 p.m. We had no issue about that.