Robert Troy (Longford-Westmeath, Fianna Fail)
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93. To ask the Minister for Health the plans that are in place to improve and expand primary care services in 2023; and if he will make a statement on the matter. [61181/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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The development of primary care services – alongside social and community care more broadly – is central to this Government's determination to deliver a high-quality, integrated and cost-effective health care system.

In addition to annual funding of €195 million allocated in Budget 2022 for the recruitment of staff to the Enhanced Community Care (ECC) Programme, a further €13.8 million was allocated in Budget 2023 to Primary Care for new developments, including for the continued roll out of Programme.

The ECC programme includes a number of elements which will enhance and expand the delivery of primary care services in the community. Amongst other initiatives, the funding will allow for the recruitment of some 3,500 additional staff, the rollout of 96 Community Healthcare Networks (CHNs), and the provision of 30 Community Specialist Teams (CSTs) for Older Persons, and 30 Community Specialist Teams for the Management of Chronic Diseases. 

To date, 2,133 staff have been on-boarded to the ECC, with 325 at an advanced stage of recruitment, a total of 2,458.2 WTEs (70% of overall recruitment), with 91 CHNs in place, 21 CSTs for Older Persons and 18 CSTs for Chronic Disease now operational.

We continue to develop new, state of the art Primary Care Centres (PCCs) to support the provision of the very highest standards of primary care.  There are now 160 PCCs open nationwide, and 12 are due to become operational over the course of 2023.

In addition, several measures pertaining to General Practice will be implemented or expanded upon in 2023. As announced, Budget 2023 will increase the eligibility of people for General Practice (GP) access cards. My officials and the HSE have made preparations for the expansion of GP care without charges to all children aged 6 and 7 and engagements with the IMO, representing GPs, are ongoing with the intention of introducing this service as early as possible.

Furthermore, from 1 April 2023, eligibility will be extended to people who earn the median household income of €46,000 or less. Further operational details will be made available prior to the commencement of this income-based expansion. It is envisaged that these measures will be supported by a significant package of additional capacity supports to GP practices.

The Chronic Disease Management (CDM) programme, which involves the ongoing monitoring of patients’ conditions, commenced in 2020 and has now been substantially rolled out. The final extension of the CDM programme will commence in 2023 and will see the Opportunistic Case Finding and Preventative components of the programme extended from eligible patients aged 65 years and over to eligible patients aged 45 and over.

The nationwide GP Access to Diagnostics programme began accepting referrals in January 2021, through the allocation of €25m in funding to provide a structured programme which facilitates direct referral by General Practitioners to diagnostic radiology services for their patients.

This enables a greater level of care to be delivered in the community, supporting patient-centred care, early diagnosis, and early intervention. Expansion of existing public hospital and laboratory services to provide GPs with a direct referral pathway for other diagnostic services (Echocardiography, Spirometry and NT-proBNP blood tests) is also targeted through this initiative, with funding allocated to operationalise these services in 2023. 

These investments and reforms are a demonstration of the commitment to shift the model of healthcare towards more comprehensive and accessible primary and community care service provision, in order to deliver better care closer to people’s home in communities across the country.