Dáil Éireann Debate, Thursday - 28 October 2004
1 Dr. Twomey asked the Tánaiste and Minister for Health and Children if her Department has deferred until 2007 or 2008 making a major investment in the non-acute sector, especially the primary care sector; and if she will make a statement on the matter. [26414/04]
View answerIt is not correct to say that funding for the non-acute sector, including primary care has been deferred to 2007 or 2008. The total capital programme for this year is €509 million. The health capital investment framework programme for the years 2004 to 2008 proposes a total capital envelope of €2.7 billion. This includes capital investment in the non-acute hospital sector.
A number of major acute hospital projects are under way which by their nature involve significant contractual funding commitments — construction, fees, equipping — for the next few years. It is in this context, allied to the multi-annual nature of the funding programme, that a greater emphasis is being placed on the non-acute programme for the latter period of the framework. This is especially the case, bearing in mind existing contractual commitments and the timescales involved in delivering the larger projects in the non-acute sector.
There is no funding for primary care in the Government's primary care strategy to which the Minister has made no reference. While this is not what makes headline news, investment in primary care, which includes general practice services and ambulance services, is a solution to the long-term crisis in health. Will the Tánaiste agree that if there is no investment in primary care, it makes the Hanly report unimplementable? The former Minister for Health and Children, Deputy Martin, stated before leaving office a month ago, that none of the €2.5 million which is being rolled out was to be invested in the non-acute hospital sector, specifically the primary care sector. In information released under the Freedom of Information Act, the Department of Health and Children said there will be no investment in primary care until 2007. Without investment in primary care, the Hanly report, as published by the Department, is unimplementable. In regard to the consultants' contract, there is no point in negotiating it unless there is major investment in primary care. The Minister has not stated where the investment in primary care is going.
I agree with the Deputy. The development of the primary care sector is central to the health strategy. Certainly the general practitioner service is the first port of call for the majority of people. I am examining how we can develop further the potential the primary care sector offers. I said in my reply that it is not correct to say that the non-acute sector will not receive substantial funding. I have a number of projects to which I can refer but I do not wish to delay the House. Among them are projects in the mental health area which are a priority for the Government. They include the facilities of the Central Mental Hospital in Dundrum which are not appropriate to the needs of today. I intend to bring forward proposals to the Cabinet shortly on that matter. It would be my intention to dispose of some of the substantial land assets available in the health sector and to use them as additional funding on the capital side for many of the projects, such as those in primary care, which the Deputy mentioned.
I agree that funding will be put into mental health services. However, I am asking specifically about primary care to which no commitment has been given in the primary care strategy. Prior to leaving office, the former Minister for Health and Children, Deputy Martin, began to speak about public private partnerships which were not referred to when the primary care strategy was published. It appears that funding in this area has come to a stop. That is the point I make because it is the solution to many of the crises in the health service. I am surprised that investment in primary care should be stopped when there is already a manpower crisis and the hospitals with the worse accident and emergency crises are those which also have the poorest primary care services. While investment in this area does not make headline news, it is vital for the health services.
I emphasise there is no question of investment in the primary care sector being dropped. Regarding the next two questions I will take, developing out-of-hours services in the greater Dublin area is crucial to relieving many of the pressures experienced by the accident and emergency departments in the Dublin area. Primary care is developed along a number of models. I look forward to the negotiations with the Irish Medical Organisation, IMO, and consultants on the changes which are necessary to implement the reform programme which the Government has under way to unsure this country has the best possible standard of health care delivery in the world. I want people to be able to come to Ireland in the future——
Dream on.
I will not dream on. That was said about the economy ten years ago. We can do it in Ireland and that has to be the ambition. That is certainly an ambition I have set for myself.
Not if the Government does not spend.
I do not believe in being defeatist like the Deputy.
For the benefit of Deputy Gormley, in regard to priority questions only the Member who submitted the question is entitled to submit a supplementary.
I was just heckling.
