I thank the Chairman and members of the joint committee for allowing the Primary Healthcare Partnership to make this presentation. I am a GP in the midlands and our group practice is representative of many around the country. I am joined by Mr. Ben Cronin, Mr. Pat Conlan and Mr. Liam Kenny. We have formed a group called Primary Healthcare Partnership, which was established to develop a primary care facility in Kildare. The message of our presentation is simple, yet of great importance. I may surprise members by saying that this presentation is not actually about our group. It is about how we can deliver a first-class, cost-effective health care system for all patients by implementing the primary care strategy in a prompt fashion. We believe this will be cash-positive to the Exchequer and will also provide positive spin-offs for other sectors in the economy.
Buildings alone are not enough. They simply provide the infrastructural environment to deliver the necessary services. We are fortunate to have a population of highly-trained GPs. We are already qualified to provide a far wider range of services than we are able to provide at present due to the constraints of the system. By using primary care manpower more efficiently, we can improve the hospital-primary care interface with marked benefits to our patients. As a result, hospitals will become more efficient in fulfilling their secondary and tertiary roles. More elective and emergency cases could be carried out in hospitals, thus significantly reducing waiting times. One of the major difficulties to date has been that many services are carried out in hospital outpatient clinics, which are often at some remove from the patient's own community. This creates logistical problems for patients and their families, with considerable cost in time and money to both service users and the Government. Providing all these extra services will require some reallocation of manpower and suitable accommodation. As mentioned previously by one or two of the groups, it is futile to rationalise hospital services and cut funding if some of the moneys saved do not follow the patient into the primary care setting.
There is an essential need for co-operation between the two main parties, namely, the general practitioners and the Health Service Executive. We must provide integrated and co-ordinated services as value for money. The business model used by GPs has provided cost-effective services to the State, with more than 90% patient satisfaction. That level is considerably higher than that of other groups. This figure is according to a HSE-commissioned report by Deloitte and Touche in 2001. It is essential that this business model be incorporated into the new primary care facilities for efficient delivery of primary care and that bureaucratic and inefficient models are not allowed to predominate.
Many of the proposed primary care facilities are in smaller provincial towns where there may be only two key occupants, namely, the HSE and general practitioners. The problem is that the HSE has expressed the requirement that such facilities should be occupied at below market rents. GPs are unlikely to leave their current accommodation to subsidise such a situation. In other words, if the proposed primary care facility is not financially viable, it will not be built. It is in the many locations throughout the country such as Carrickmacross, Croom and Glin that this will impact most negatively. This is where the role of capital allowances is vital. The purpose of these allowances is to catalyse the provision of primary care facilities to enable the delivery of the primary health care strategy in a fast and cost-effective way throughout the country. As Deputy Reilly and other speakers noted, 2000 was the year the primary health care strategy was drawn up. That was nine years ago. If we had had a specified limited tax allowances scheme for the past seven years, this could all have been rolled forward in a timely fashion.
I hope I will not be timed on that aside.
