Keith Swanick (Fianna Fail)
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I thank the Minister of State for coming into the House to take this matter. I am hopeful she will be able to allay the fears of the communities of Elphin and Strokestown who are hearing reports of the potential closure of one or both of their health centres once the new primary care centre opens in Boyle, County Roscommon. The opening of the new centre is warmly welcomed. Providing dental services, occupational therapy, physiotherapy, speech and language therapy and public health nursing services all under the one roof will be of fantastic benefit to the community. I know this because of my experience in general practice in Belmullet, County Mayo, but I am also aware of how destitute my patients would be without these services and the hardship it would cause if they were forced to travel 50 miles to Castlebar to avail of them.

Shortly before the Easter break, the Minister of State at the Department of Health, Deputy Helen McEntee, reiterated in the House that one of the Government's key priorities was to implement a decisive shift in health services towards primary care. She stated: "Our ultimate goal and, as Minister of State with responsibility for older people, my goal is to make sure that people get the care they need as close to home as possible and have access to a greater range of health and social care services within their community." Will the Minister of State, Deputy Corcoran Kennedy, advise what "as close to home" and "within their community" mean in this context? Does it mean within walking distance or the county boundary? Whatever way we look at it, a healthy person would have no problem in travelling a distance to a primary care centre for treatment, but, as I have said previously, we need to remember that most people visiting GPs and care centres are not in the whole of their health. They are in need of medical attention and we can assume in pain or distress. The fact that they cannot visit a doctor in their own locality, in close proximity to their home, only adds to their distress.

The journey from the health centre in Strokestown to the new primary care centre in Boyle is at least a half an hour's drive. The smaller care centres around the country are vital in so far as they act as a filter to the larger centres and the wider hospital network, thus preventing an additional workload at these highly pressurised sites. In response to a parliamentary question submitted by Deputy Billy Kelleher on the future of services in Elphin and Strokestown health centres, Mr. Frank Murphy, head of primary care services, stated the services being provided from existing health centres would be reviewed in the context of whether they would be more appropriately delivered from a primary care centre. I am referring to two small health centres in two small villages facilitating older people in rural communities. Will the Minister of State provide further clarity on the future of these centres which cater for a large ageing population in great need of them?

Marcella Corcoran Kennedy (Offaly, Fine Gael)
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I thank Senator Swanick for raising this issue. I know his experience as a GP in addition to being in the House is a motivating factor.

Enhancing and expanding capacity in the primary care sector is crucial to ensuring delivery of a preventive, joined-up approach to the management of the nation's health and the modernisation of primary care delivery. In a fully developed primary care system, 90% to 95% of people's day-to-day health and social care needs can be met in the primary care setting.

The development of primary care centres to accommodate primary care teams and, where possible, GPs in the one location is a key enabler for the delivery of primary care services. Primary care centres facilitate the shift from acute care towards primary care because of the range of multi-disciplinary services they can provide and the role they can play in keeping people who do not need to be in an acute setting out of hospital.

Significant investment has been made in the development of primary care centres and continues to be put in place. These additional primary care facilities across the country will be provided through a combination of direct build, through public private partnership and by way of the Health Service Executive’s primary care operational lease mechanism. Boyle primary care centre is one of the 14 facilities being developed under the public private partnership model and is expected to open in the third quarter of 2017.

The Health Service Executive has advised that the Elphin health centre provides a range of services to the local community delivered by two GPs, one public health nurse and one visiting speech and language therapist while the Strokestown health centre provides the service of one GP. The HSE has advised that no decision has been made to close any health centres located in close proximity to the development of new primary care centres. This is the position for Elphin and Strokestown health centres. Once newly opened primary care centres become operational, the services being provided from existing health centres will be reviewed in the context of whether these services would be more appropriately delivered from a primary care centre. A decision will then be made on the future of some health centres, with the HSE advising that many of the health centres will remain where GPs are in situand not relocate to a primary care centre.

It is very important to stress that from the point of view of people using the wide range of services provided by the HSE at community level, the objective is to ensure services are responsive to people’s needs and enable them to receive a joined-up service that results in the most favourable health outcomes for patients. These primary centres will, when completed, significantly enhance and expand capacity in the primary care sector to deliver on this. This is very much in line with the policy of Government that people access the great majority of their health care needs in the community and, as far as possible, in one location.

Keith Swanick (Fianna Fail)
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I thank the Minister of State. I welcome that the HSE has advised no decision has been made to close the health centres in Elphin and Strokestown. While the Minister of State has said some services may be relocated, she acknowledged that where a GP remains in a health centre, it will remain open. It is a very important point. Once a health centre is staffed by a GP, the health centre cannot be closed. It is one message I want to send out today.

While I welcome the development of primary care centres, it is not all about bricks and mortar and building fancy new buildings; it is about the activity that happens in the primary care centre. Often where care is delivered close to communities and where people have easy access to care it is the best form of care and it leads to fewer referrals to hospitals and earlier discharges. I welcome that no health centre will be closed as long as a GP remains in situ.