Dáil Éireann Debate, Wednesday - 20 November 2013
204. Deputy Róisín Shortall asked the Minister for Health if he will report on the status of the primary care strategy; and his plans to expand the capacity of primary care through the recruitment of additional therapy staff and practice nurses. [49717/13]
View answerThe implementation of the Primary Care Strategy is an essential component of the health service reform process. The key objective is to develop services in the community which will give people direct access to integrated multidisciplinary teams of general practitioners, nurses, physiotherapists, occupational therapists and other allied health professionals. At the end of September 2013, there were 423 Primary Care Teams operating, i.e. holding clinical team meetings involving GPs and HSE staff. These Teams provide services for almost 4 million of the population with over 2,600 HSE staff members and almost 1,700 GPs participating.
The Government plans to implement the following key measures in primary care over the remainder of its term in office:
- Introduction of a universal GP service free at the point of access;
- Introduction of a new GP contract;
- Phased roll out of chronic disease management programmes;
- Expansion of the primary care workforce; and
- Continued development of the primary care infrastructure.
The Government is committed to introducing, on a phased basis, a universal GP service by 2016, as an essential prerequisite to the introduction of Universal Health Insurance. As announced in the Budget, it has been decided to commence the roll-out of a universal GP service by providing all children aged 5 and under with access to a GP service without fees. Additional funding of €37 million has been provided to meet the full year cost of this measure. The new General Practitioner (GP) contract will focus on prevention and will include a requirement for GPs to provide care as part of integrated multidisciplinary Primary Care Teams. The formulation of the new contract will have regard to the constraints of Irish and EU Competition Law, particularly with regard to the setting of fees and allowances.
The HSE is developing chronic disease management programmes to improve patient access and to manage patient care in an integrated manner across service settings, resulting in best health outcomes, enhanced clinical decision making and the most effective use of resources. The HSE National Service Plan and Operational Plan for 2014 will see a continued focus on the Asthma, Diabetes and COPD programmes which are particularly relevant to primary care.
Funding of €20 million has been provided to recruit 264.5 additional Primary Care staff, including Public Health Nurses; Registered General Nurses; Occupational Therapists; Physiotherapists; and Speech & Language Therapists. Almost 100 of these posts are now filled or have start dates agreed and approximately 80 are at final stages of recruitment (i.e. Garda clearance). In addition, since the Health (Provision of General Practitioner Services) Act 2012 came into effect on 12 March 2012, an additional 246 GPs have obtained a GMS contract.
Primary Care Centres (PCCs) are being developed through a combination of public and private investment to facilitate the delivery of multidisciplinary care. Considerable progress has been made and 34 PCCs have opened since March 2011. Work is underway at 15 locations involving a combination of refurbishment, extension of properties and new build through direct exchequer investment. Under the 'operational lease' mechanism, construction is underway at 6 locations and planning permission has been granted at an additional 22 locations. In addition, the HSE is working with the National Development Finance Agency to progress PCCs through the Public Private Partnership programme. I am satisfied that the implementation of these key measures will play a significant part in the refocusing of health services in line with the Government's health reform programme.
