Bernard Durkan (Kildare North, Fine Gael)
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Question 185: To ask the Tánaiste and Minister for Health and Children her plans to improve, enhance or otherwise upgrade the various health centres in County Kildare having due regard to demographic trends; and if she will make a statement on the matter. [15705/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The Health Act 2004 provided for the Health Service Executive, which was established on 1 January 2005. Under the Act, the executive has the responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. This includes responsibility for the provision of health centres. Accordingly, my Department has requested the chief officer for the executive's eastern regional area to investigate the matter raised and reply directly to the Deputy.

Bernard Durkan (Kildare North, Fine Gael)
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Question 186: To ask the Tánaiste and Minister for Health and Children her proposals to upgrade health centres with a view to relieving some of the pressure on hospitals; and if she will make a statement on the matter. [15706/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The strategy, Primary Care: A New Direction, sets out the Government's broad vision for the development of primary care as the central focus for the delivery of health and personal social care services in a modern health system.

The strategy aims to shift the emphasis from the current over-reliance on acute hospital services to one where patients will have direct access to an integrated multidisciplinary team of general practitioners, nurses, health care assistants, home helps, occupational therapists, physiotherapists, and social workers in their local community. As the new primary care model is implemented, a wider network of other health and social care professionals will also provide services for the population served by each team.

The strategy provides a template for the development of primary care services over a period of ten to 15 years. The full implementation of the primary care strategy will require significant investment, over a sustained period, in order to expand capacity and to enable primary care to fulfil its role as the cornerstone of our health system. There are three broad approaches which will be taken to enable this to happen. These are: revenue and capital investment by the State in order to deliver additional services in primary care; a structured role for the private sector in the development of facilities and possibly also the delivery of services; and the substantial reorganisation of the resources already within the health services.

In relation to implementation, one of the first steps has been to establish an initial group of ten primary care teams, with supplementary funding, to enable existing staff resources within the public system to be augmented. These teams are intended to demonstrate the primary care model in action and also to enable practical experience to be gained of the process involved in establishing a primary care team.

Among the enhanced and expanded range of services which these teams are providing or developing are improved access to physiotherapy and occupational therapy, shared care arrangements with general hospitals and social work services focusing on general family support needs.

A significant element in the implementation of this strategy will be the reorganisation and reconfiguration of resources and services already within the health service. This reflects also one of the core principles underpinning the health service reform programme. This must be addressed by the Health Service Executive in order to provide a firm basis for the development of primary care teams and networks as the standard model of service delivery. I am aware that considerable work has already been undertaken by the former health boards over the past two years to map out the proposed numbers, locations and configuration of future primary care teams and the resource requirements associated with these. The HSE must complete this task to provide a firm basis for the reorganisation of resources within primary care.

All the investment needed to enable implementation of the primary care strategy need not involve the public sector and I am committed to developing policy in ways which will stimulate private sector investment in the development of both facilities and services. In the same way as we have seen considerable private sector interest in the development of hospitals and long-term care services, I see much potential for such developments in primary care to complement investment by the State. I have asked my Department to consider how this agenda can be advanced in a way which will harness this undoubted potential within the non-State sector and so enable and support the delivery of integrated primary care services in line with national policy.