Martin Ferris
Question:73 Mr. Ferris asked the Minister for Health and Children the progress made to date on the development of primary care as promised in action 77 of Quality and Fairness, a Health System for You. [22589/03]
Written Answers. - Primary Care Strategy.
With regard to the implementation of action 77 of Quality and Fairness, there are out of hours co-operatives in all health board areas at present, the majority of which provide full out of hours cover while, others in the ERHA area provide limited hours of operation. The level of patient satisfaction with the service being offered by the co-ops is very high from both the patient and provider perspectives. Independent evaluations undertaken in two health board areas show that the initiatives provide significant enhancement in service. Surveys of patient satisfaction with the out of hours services being provided continue to be taken by the co-operatives. Co-operatives show in a very real way what can be achieved when people come together in a constructive partnership of ideas and objectives. Government support for the development of general practitioner out of hours co-operatives nationally for the period 1997 to 2003 amounted to €46.5 million.
This type of co-operative serves as a basis for providing not only general practitioner services at nights and weekends. In time, they can also be developed to provide a much wider range of community based health services that ensure that communities, irrespective of size and distance from major urban centres, enjoy appropriate access to primary care services. Indeed, the use of the many technological advances available to us today can be fully exploited to bring considerable benefits to remote areas.
My Department continues to provide funding for projects under the research and education fund. This fund taken from the indicative drugs target scheme allows projects to be undertaken which will be of benefit to general practice as a whole. The normal recipients are Departments of general practice at universities or doctors or other health professionals currently in general practice.
With regard to national initiatives to complement the primary care model, my Department requested the health board chief executive officers to establish a national group to co-ordinate the preparation of needs assessments in accordance with action two of the strategy, Primary Care – A New Direction. The group has developed a set of agreed definitions and templates for the completion of the needs assessments on a regional basis. Work has been undertaken by the individual health boards and this will be followed by the development of models for use at local level for primary care team and network populations.
I have also provided funding of €360,000 for the establishment of three research fellowships in primary care, in the university departments of general practice. The fellowships, which will be funded through the Health Research Board and available to the professions who will work in the new primary care teams, will enable the researchers to work on topics relevant to the implementation of the primary care strategy.
Furthermore, my Department has also agreed to make funding of €750,000 available over a three-year period to the university departments of general practice to support specific activity in support of the implementation of the primary care strategy. Funding is also being provided to the Irish College of General Practitioners for a three year period to enable the appointment of a research development officer.
Billy Timmins
Question:74 Mr. Timmins asked the Minister for Health and Children the progress made to date in the ten pilot projects of the primary care strategy; when the projects will be assessed; and when the next stage of the strategy will be initiated. [22466/03]
In October, 2002 I gave approval to the establishment of ten primary care implementation projects – one in each health board area. These projects are building on the services and resources already in place in the locations involved so as to develop a primary care team in line with the multidisciplinary model described in the strategy. To date, I have committed a total of €8.4 million to these projects over 2002 and 2003. Revenue funding of €877,000 was provided in 2002, and this allocation was increased to €4.5 million in 2003. Once-off capital funding of €2 million and a further €1million in respect of information and communications technology support for the teams was also provided in 2002.
The spread of locations, ranging from the centre-city urban to the rural communities of the west of Ireland, has been chosen to reflect the variety of circumstances around the country in which primary care services must be delivered and to explore, in a practical way, how primary care teams will operate. Each location has its own intrinsic challenges and each primary care team will have to adapt to the needs of the area and community it serves. The objective is that, when the teams are in place, more than 80,000 clients altogether will benefit from having direct access to the improved range of services provided by their primary care team.
My Department has set an objective for each project to have its team operational by the end of this year. Projects are currently at different stages of development, with a number already providing new or enhanced primary care services to their target populations. Even at this early stage, some of the benefits which were anticipated for both service users and providers are, I understand, becoming evident in these cases.
My Department is in ongoing contact with each health board to monitor progress with each implementation project. One of the priority objectives over the coming months will be for the Department and the health boards to work together to develop an appropriate standard system of monitoring and evaluation for these and other primary care projects.
My Department is at present developing a policy document which is intended to expand upon the key principles in the strategy to assist in informing the process of forming primary care teams and networks on a system-wide basis. I see this as an important step in helping the different parties, in terms of service planners and providers, together with potential private entrepreneurial interests, to engage in the development of capital facilities to support the model of service outlined in the primary care strategy.
The primary care strategy also identified that a significant component of the development of primary care teams, in the short to medium term, would involve the reorientation of existing staff and resources. To this end, my Department will shortly be formally asking the health boards to examine how the existing primary/community care resources can best be reorganised, so as to give effect to the application of the teamworking concept, as described in the strategy, on a wider basis and to map out the geographical areas to be served by primary care teams in the future.
Question No. 75 answered with Question No. 25.
Question No. 76 answered with Question No. 28.