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Priority Questions - Primary Care Strategy

Tuesday, 27 March 2012

Dáil Éireann Debate
Vol. 760 No. 3

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 3.  Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher  asked the Minister for Health Information on James Reilly Zoom on James Reilly  his views that there are sufficient resources being directed to ensure the primary care strategy is implemented in full; and if he will make a statement on the matter. [16567/12]

Minister of State at the Department of Health (Deputy Róisín Shortall): Information on Róisín Shortall Zoom on Róisín Shortall The key component of the primary care strategy is the development of services in the community to give people direct access to integrated multi-disciplinary primary care teams, PCTs, consisting of general practitioners, nurses, physiotherapists, occupational therapists and others. Following changes to team boundaries across the country to integrate with the HSE’s new integrated service areas, a number of PCTs have been merged. The total number of teams targeted by the HSE for establishment by the end of 2012 now stands at 486. At the end of February 2012, 400 PCTs were operating, that is, holding clinical team meetings. Funding of €20 million has been provided for in the HSE’s national service plan for 2012 to fill as many vacancies as possible that have arisen as a result of the recent public service retirements and to expand existing arrangements where sessional services are provided by allied health professionals. This will be increased to €25 million if it can be established that there is scope for further savings of €5 [599]million in demand-led schemes. At this time of scarce national resources, it is essential that such posts will be allocated according to an objective assessment of needs. The HSE is accordingly analysing the current provision of posts in proportion to population and population health needs to identify which areas are least well served.

The allocation of the extra posts will be subject to approval by the universal primary care project team, which has been tasked with working through the issues relating to the programme for Government commitments on primary care.

Deputy Billy Kelleher: Information on Billy Kelleher Zoom on Billy Kelleher The primary care strategy is a primary objective in the programme for Government. However, questions arise for the role of primary care as a front line service in the context of the moratorium and the early retirement of highly skilled professionals. Is it possible that the moratorium will delay the roll-out of the primary care strategy because insufficient human resources will be available for deployment in the areas where they are most needed?

The Government has patted itself on the back for the progress made on the strategy to date but when one drills into the figures many of the primary care teams are barely up and running. They may be holding meetings but whether they are delivering primary health care is another question. Does the Minister of State accept that while a considerable number of meetings are being held they have not reached the point of delivering care?

Is the Minister of State seeking private funding for the strategy and has an approach been made to her Department by people who are willing to provide private investment for primary health centres?

Deputy Róisín Shortall: Information on Róisín Shortall Zoom on Róisín Shortall I accept there has been much talk but little action on primary care over the past 11 years. More decisions have been taken on developing primary care over the past year than during the previous decade. I am pleased to say that the budget includes a special allocation of €20 million for primary care, which will enable us to recruit the equivalent of 300 posts over the coming weeks. That money will be prioritised for the filling of key front line primary care posts, including public health and community nurses, occupational therapists and physiotherapists. I have also put in place a system which will allow us to identify gaps in front-line services. There are considerable gaps in primary care posts across the country. I look forward to the recruitment of these posts over the coming weeks and months. That will greatly strengthen primary care, which is what should have been done a long time ago.

Deputy Billy Kelleher: Information on Billy Kelleher Zoom on Billy Kelleher The Minister of State said she would need approximately €50 million a year so her budget is considerably less than that for which she hoped.

Deputy Róisín Shortall: Information on Róisín Shortall Zoom on Róisín Shortall The Deputy is mixing up staff and centres here.

Deputy Billy Kelleher: Information on Billy Kelleher Zoom on Billy Kelleher Let us be clear that she still does not have sufficient funding to implement the proposals outlined in the programme for Government. On the broader issue of the provision of primary care, at last week’s committee meeting the Minister spoke about a smaller hospital strategy. Will the small hospital strategy and urgent care units be part and parcel of primary care — in other words to keep people out of acute hospitals — or will we have another strategy with regard to the smaller hospitals on top of the primary care strategy? That does not seem to fit into the overall measures proposed in the reconfiguration, some of which we support and many of which we do not.

Deputy Róisín Shortall: Information on Róisín Shortall Zoom on Róisín Shortall It is a framework for smaller hospitals and not a strategy. However, we have a primary care strategy and I remind the Deputy that is an 11-year old strategy. We are taking that seriously now. That is why I am very pleased we can now proceed to recruit an [600]additional 300 people in the health service. I am glad to say that this week the HSE is engaged in drawing up the job specifications and putting together the panels to recruit those 300 people. It is a really good news story about what is happening in the health service. We will be recruiting 300 new front line people in the health service to deliver primary care. I point out that this is Revenue money — it is €20 million for 300 additional posts. The Minister, Deputy Reilly, will speak later about the capital funding. I repeat that 11 years down the road it is disgraceful that there are so few primary care centres. We will address that as a matter of urgency in the coming months.

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