Dan Neville (Limerick, Fine Gael)
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Question 191: To ask the Minister for Health about the working relationship proposal between the primary care teams, as outlined, and the multidisciplinary community mental health teams. [7098/12]

Róisín Shortall (Dublin North West, Labour)
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There is a commitment in the Programme for Government to introducing a better and more efficient health system, a single-tier health service that will deliver equal access to care based on need, not income. The development of primary care services must be an essential component of the health service reform process. In a developed primary care system, up to 95 per cent of people's day-to-day health and social care needs can be met in the primary care setting.

Fully developed Primary Care Teams would give people direct access to integrated multidisciplinary teams of general practitioners, nurses, physiotherapists, occupational therapists and others. There are currently 425 Primary Care Teams in place, albeit at varying stages of development. The HSE has committed in its Service Plan to having 489 operational teams in place by the end of this year.

It is hoped that Primary Care Teams will be supported by a wider range of professionals, including pharmacists, dieticians, psychologists and chiropodists who will form a Health and Social Care Network. The vast majority of specialist based services could be organised at this level, including Community Mental Health Community Teams. Guiding the development of our mental health services is A Vision for Change , which is predicated on the existence of a robust primary care system. When an individual experiences a mental health problem, their first formal attempt to seek help is usually to contact their General Practitioner or other member of a Primary Care Team. This contact can be the key to a timely and successful resolution of their mental health problem.

Chapter Seven of "A Vision for Change" makes recommendations in respect of the provision of mental health care in a primary care setting. A key aim is to develop a flexible model of collaborative working between primary care and mental health services which enhances GPs' skills in identifying and treating mental illness and emphasises the development of close linkages between the two services.

Through the "Shared Care Model" and the "Team based approach to Mental Health in Primary Care", the primary care setting can provide sufficient access to appropriate care for people with short-term mental health difficulties and can also balance the need to ensure that needs of people with severe and enduring mental health problems are not overlooked.

The Shared Care model allows for the appropriate provision of mental health care at primary care level, along with access to advice, routine and crisis referral to the local CMHT, with a single point of access for referral. It may also be possible to create links with the mental health professionals in community services in order to provide this primary care level of mental health input. This currently happens to some extent with services for children and it is recommended that this be extended to cover work with adults in primary care. The shared care model can be seen to offer the 'best of both worlds' with the opportunity to provide good-quality holistic care. It is envisaged that a shared care model would lead to a pooling of expertise and enhanced creativity in problem-solving.