I thank the committee for the opportunity to brief it on our progress in transforming health and social care services, particularly in terms of the development of primary care services in local communities. Following my opening comments, I would welcome members' questions. With my colleagues, I will do my best to answer all of them.
In October 2006, we launched our transformation programme, at the heart of which is our overriding objective to provide the public with easier access to the right care in the right place at the appropriate time. We aim to provide up to 90% of the care ever needed by people within either their local communities or their homes. This approach is better for patients than the traditional approach where we relied too heavily on acute hospitals to provide care that could, with the right supports, have been provided locally. It will also enable us to free our acute hospitals to focus on delivering the types of specialist care that can only be provided therein. We aim to have both community and hospital services working hand in glove as a single integrated service and to make patient journeys for health services to be as seamless and free of delays as possible.
Central to this strategy are primary care teams, the building blocks for the new health service in which the emphasis is on building community-based teams. Primary care teams provide a one-stop approach and can meet or arrange the majority of care required by the public, be they general practitioner services, physiotherapy, public health nursing, diagnostics or so on. We plan to have a primary care team for every 8,000 people.
A typical team will consist of GPs, nurses, home helpers, physiotherapists and occupational therapists. All of the team's health care professionals will work together to develop individualised care plans for patients, particularly those with chronic illnesses and other complex needs. They will share information and their respective skills to ensure that patients with the greatest need receive services in a timely and co-ordinated way.
Depending on their needs, patients can be linked through their teams with the services of other primary care professionals, such as mental health services, specialist child care and disability services. If hospital care is necessary, links and arrangements can be made with local or specialist hospitals. This access to hospital services is an important feature of the teams, whether it entails access to specialist consultants or diagnostic services, such as X-rays or ultrasounds, and is a central tenet of our integrated system. The planning of admission to and discharge from hospitals is a strong feature of the new service, with strong links between hospitals and primary care teams. This integration between primary care and specialist services within the community will ensure that patients get timely admissions when required and do not spend unnecessary time in hospital.
From the point of view of patients, primary care teams provide them with local, identifiable and accountable entry points into the health and social care service. When they access a service, they should have the confidence to know that their further journeys should be seamless and free of delays.
Primary care teams are also involved in health promotion to improve the overall health of local populations and provide a range of services for patients with existing conditions, such as diabetes, respiratory disorders, cardiovascular ailments and depression, to name but a few.
Following an extensive planning exercise, we have identified that we need a total of 530 primary care teams. We plan to have all of them in place by 2011. By the end of last December, 93 teams were in place and their meetings with HSE clinical and therapy staff were attended by almost 300 GPs or their representatives. These meetings discuss patient cases and agree schedules of care. Our target for 2009 is to have 210 teams operating, representing 40% of our overall total of planned teams. We are on schedule to achieve the target.
Central to achieving our transformation objective is the need to arrange the way in which front line community staff work with primary care teams. An extensive exercise is currently under way to review and reconfigure the existing staff working across primary, community and continuing care with a view to meeting the staffing needs of the planned primary care teams and other specialist services. Where possible, primary care teams are based in a single facility to provide easy accessibility for patients and to enhance multidisciplinary teamwork. A programme to procure primary care centres to accommodate the emerging teams was initiated by the HSE in 2007. Approximately 200 are under consideration. We will be leasing the public health infrastructure elements, by way of a public private partnership initiative. This approach has yielded significant discounts on the open market prices. The infrastructure programme aims to have all sites identified by the middle of this year, with the first group of 80 to open by the end of 2010 and the full complement to open in the course of 2011. In addition to these developments, we are continuing to develop primary care centres funded through the HSE capital allocation programme. A number of these centres are at an advanced stage of development.
In addition to the core services provided by the primary care teams, such as GPs, public health nurses, many additional and modern ways of providing services have been developed. Most of the initiatives have been developed after involving patients and listening to their views on services. This type of patient involvement is a key component of our strategy to match services to patient needs.
For example, some of primary care teams in Skibbereen, Mizen and Dunmanway have wound assessment clinics. The primary care teams in Lifford and Castlefin, Donegal, have established a dedicated diabetic clinic for patients with type 2 diabetes. Specific diabetes procedures have been developed in Banagher and Kilcormac primary care teams. The Togher primary care team in Cork has developed a specific programme that links the primary care team with local palliative care services. Early pregnancy initiatives have been developed in the Ballymun primary care team. There are five cancer pilot programmes based in five primary care teams. Another example is the availability of X-ray services for GPs participating in the Arklow primary care team.
I am pleased to have had the opportunity to update members on the progress in the development of primary care service teams. We welcome any questions or issues that members would like us to address.