Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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151. To ask the Minister for Health the current status of primary care centre provision, including numbers of centres and plans to build or procure further centres. [9512/15]

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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165. To ask the Minister for Health if he will provide an update on the roll-out of the Government's primary care strategy; the number of primary care centres currently in operation; the services currently available in each, as well as future plans for increased service provision or the development of additional centres; and if he will make a statement on the matter. [9526/15]

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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166. To ask the Minister for Health if he will provide an update on the progress that has been made towards implementing the programme for Government commitment to widening access to primary care. [9527/15]

Kathleen Lynch (Cork North Central, Labour)
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I propose to take Questions Nos. 151, 165 and 166 together.

The implementation of the Primary Care Strategy is an essential component of the health service reform process. The key objective is to develop services in the community which will give people direct access to integrated multi-disciplinary teams of general practitioners, nurses, physiotherapists, occupational therapists and other allied health professionals.

The development of the Teams is a work in progress with enhancements occurring in terms of team membership and organisational delivery over time. At the end of December 2014, core Team staff amounted to approximately 3,000, providing services for almost 4 million of the population.

264.5 Primary Care Team posts (Public Health Nurses; Registered General Nurses; Occupational Therapists; Physiotherapists; and Speech & Language Therapists) were approved in 2013. 248.5 posts are now filled or start dates agreed. The recruitment process is continuing regarding the remaining posts.

There are currently 11 Community Intervention Teams (CITs) in place in Dublin North, Dublin South, Cork, Galway, Limerick, Clare, Tipperary, Carlow/Kilkenny, Wicklow, Naas and Drogheda. CITs work in partnership with Primary Care Teams, General Practice, Community Response Beds, community nursing, home support services, acute hospitals and other professional, voluntary and external providers to deliver enhanced services and patient centred care in the most appropriate setting. The CIT provides a rapid and integrated response to an appropriate patient with an acute episode of illness who requires CIT services for a defined/short period of time in the community/home, thus helping to increase hospital avoidance and earlier discharge from acute hospitals.

The development of Primary Care Centres (PCCs), through a combination of public and private investment, is supporting the delivery of an enhanced range of multi-disciplinary, locally accessible primary health care services. To date, there are 86 Primary Care Centres in operation throughout the country, 43 of which have opened since 2011.

There are currently 37 locations where Primary Care Centres are at an advanced planning stage using one of the three methods of delivery (Direct build by HSE; Public Private Partnership - PPP project; or Operational Lease with the private sector.

In November 2014, the HSE advertised an additional 73 locations for delivery of Primary Care Centres by Operational Lease. January 16, 2015 was the closing date for receipt of Expressions of Interest. The HSE is reviewing all Expressions of Interest to determine which are suitable for more detailed consideration and progression to the next stage of the process.

In general, services provided in PCCs include: Public Health Nursing; Physiotherapy; Occupational Therapy; Speech and Language Therapy; Primary Care Social Work; Primary Care Counselling; Dietetics; and Podiatry. Some centres also provide additional services such as Minor Surgery, Mental Health services, Pharmacy and Dental services.

The Government is committed to widening access to primary care. This includes introducing, on a phased basis, a universal GP service without fees. This process is at an advanced stage in respect of the provision of GP services without fees at the point of access for all children under six years. The objective is to have this phase of universal GP care in place in Quarter 2, 2015, subject to the conclusion of the present discussions with the Irish Medical Organisation and the completion of a fee-setting process. The Government is also prioritising GP care without fees at the point of access for persons over 70 years. The Bill to enable this will be published shortly and the aim is for the service also to commence in Q2, 2015.

Last week the Department of Health, the HSE and IMO signed a Memorandum of Understanding which commits the parties to commence substantive negotiations on a new comprehensive GP contract no later than 31 March 2015, with a view to concluding within 12 months. This agreement will allow discussions on the further extension of universal GP care beyond the under sixes and over 70s and will have a focus on chronic disease management.

The HSE has identified an initial five Integrated Care Programmes for implementation in 2015, including the Integrated Care Programme for the prevention and management of Chronic Disease.

In 2013, the Government approved funding for the appointment of 17 Integrated Care Diabetes Nurse Specialists to support the phased roll out of the National Integrated Care Diabetes Programme. To-date, 16.65 Whole Time Equivalent nurse specialists have been recruited. Work is also underway in the HSE on an implementation plan for the National Clinical Programme for Asthma’s Model of Care.

The HSE’s 2015 National Service Plan (NSP) commits the HSE to roll out a pilot, to provide GP direct access to ultrasound, at approximately eight primary care sites, across the South and West, from early 2015. The pilot will aim to clear any existing hospital waiting lists for GP referrals to ultrasound.

The NSP also makes a commitment to pilot the provision of additional minor surgery services in agreed primary care settings and sites. This will contribute to a reduction in the waiting lists for minor surgery procedures in hospitals. The intention is to make this pilot service available in all of the HSE's Community Healthcare Organisations, ensuring local access for patients.

The implementation of the recommendations of the Community Healthcare Organisations (CHOs) Report, including the establishment of the CHOs and their management structures, has been listed as a key priority of the HSE’s National Service Plan for 2015. The Report, which was launched in October 2014, sets out plans for a comprehensive reorganisation of health services outside the acute hospital system. The primary focus is to provide the maximum proportion of care to people in the communities where they live and to achieve joined-up, integrated services.

The 17 Integrated Service Areas are being replaced by nine Community Healthcare Organisations. Existing resources will be reorganised into 90 Primary Care Networks, each serving about 50,000 of the population. Each network will be headed by an identified, accountable person responsible for care delivery by professionals such as nurses, therapists and social workers so as to meet a wide range of people’s needs in a joined-up way. The new structures will have a strong focus on building good linkages with the acute hospital system so that people’s care pathways are appropriately planned and their needs met in the right setting.