The health strategy, entitled Quality and Fairness, acknowledged the central role of primary care in a modern health service. In recognition of this central focus on primary care services a separate strategy document, entitled Primary Care: A New Direction, was published in November 2001. The strategy sets out the Government's vision for integrated team based primary care services and provides a template for their development over a period of ten to 15 years.
Following the launch of the strategy a small task force was established in my Department to give an initial impetus to implementation. My Department continues to drive the implementation of the primary care strategy and to develop policy in this regard. The implementation process is overseen by the national primary care steering group, which is representative of the broad range of stakeholders, and considerable work has been undertaken by the former health boards to advance implementation.
There are three broad approaches required to enable the primary care strategy to be implemented. These are: revenue and capital investment by the State to deliver additional services in primary care; the substantial reorganisation of the resources already within the health services; and a structured role for the private sector in the development of facilities and possibly also the delivery of services.
An initial ten primary care teams have been developed, with funding to enable existing staff resources within the public system to be augmented with additional health professionals. These teams are intended to demonstrate the primary care model in action and also to enable practical experience to be gained of the process involved in developing a primary care team and providing an expanded range of services.
Work has already been undertaken by the former health boards to map out the proposed numbers, locations and configurations of future primary care teams and networks and the resource requirements associated with these. The Health Service Executive must complete this task to provide a firm basis for the future organisation of resources within the new unified health delivery system of the Health Service Executive, and incorporating the significant numbers of staff and contractors already involved in the delivery of primary care services.
The Government has supported the development of out of hours co-operatives to provide the benefits of reliable out of hours services to the public. Between 2000 and 2004, a total of €72.882 million was allocated to the former health boards for out of hours co-operatives nationally and, in 2005, €31.98 million has been included in the baseline funding to the Health Service Executive, which includes €6.5 million of additional funding.
In 2005, an additional €5 million in revenue funding has been provided to support the implementation of the strategy, bringing total ongoing additional revenue funding to €12 million per annum. To date, capital funding of €2.725 million and a further €1.8 million in respect of information and communications technology supports have been provided to facilitate the provision of appropriate facilities and ICT supports for the initial primary care teams.
Work is almost complete on a strategy and action plan on information and communications technology, ICT, for primary care. This will provide a basis for the development of ICT systems which support interdisciplinary primary care and which also facilitate the delivery of care in an integrated way across all sectors within the health service.
It is clear that the existing network of community health centres and general practice premises is not adequate to meet the needs of primary care teams. To ensure that appropriate facilities are developed on the required scale, resources other than those of the Exchequer will be required and, indeed, this is in line with the historic practice, whereby there has been a mix of public and private facilities provision with, for example, general practitioners in many cases funding their own practice premises. In this regard, the strategy emphasises the need to gain full benefit from existing buildings and to fully explore opportunities for private investment and public private partnerships in implementing the development programme.
Many primary care services are already delivered by private and non-State contractors. I am committed to developing policy which will stimulate private sector investment in developing facilities and services and also support much enhanced collaborative working between the public and private sectors. My Department is considering how this agenda can be advanced so as to harness the undoubted potential within the non-State sector and so enable and support the delivery of integrated primary care services in line with national policy.