Health and care services

Promoting primary care

Health Minister Simon Harris breaks ground at a new primary care centre in Boyle, County Roscommon.
Health Minister Simon Harris breaks ground at a new primary care centre in Boyle, County Roscommon.

The current Programme for a Partnership Government endorses a “decisive shift towards primary care” through the construction of an additional 80 primary care centres eolas reports.

Since the late 1980s, successive governments have committed to the expansion of the community-based delivery of healthcare through the development of primary care centres. Health Minister Simon Harris has vocally acknowledged this litany of rhetoric and reiterated his own commitment, emphasising: “One of my priorities will be to implement a decisive shift of the health service to primary care, with the delivery of primary care in every community.” The Minister has expressed a desire to move away from an obsession with acute hospitals and argues that 95 per cent of healthcare obligations can be met within a community context.

At their most basic level, primary care centres incorporate community and public health nursing teams and home helps. However, the optimal objective is for each centre to provide a network of multidisciplinary services through a primary care team. This can incorporate GPs, nurses, physiotherapists, social workers, various therapists and other health professionals all occupying a single site. These teams can then refer patients to a colleague within the same building, without a need to delve into or contribute to a muddle of HSE bureaucracy.

Principally, by tailoring services in correlation with the dominant characteristics of the local community, primary care centres can aim to ensure good health and wellbeing as opposed to merely treating illness. By facilitating this shift, and focusing on prevention and early detection rather than treatment, there is a potential to obtain better health outcomes.

In theory, primary care is designed to decentralise healthcare, ensure a local delivery of services, streamline patient experience and ease pressure on acute hospitals. However, due to the current inadequacies in the volume of primary care centres, an excessive number of people have no alternative but to seek care within acute hospitals.

Earlier this year, the European Investment Bank (EIB) announced its commitment to providing a €70 million loan for investment in Irish healthcare. The ability to provide primary care infrastructure is dependent upon suitable locations being made available. Four years ago the Government announced its plans to increase the stock of primary care centres. EIB funding will support the construction of 14 selected sites (cut from an initial list of 35) in rural areas, as well as areas of urban deprivation.

This move heralds a European first in regards to specific investment for primary healthcare and represents almost 50 per cent of the total cost. The 25-year public private partnership (PPP) project is intended to support Minister Harris’ efforts to move towards community care provision by addressing existing infrastructure deficiencies. The Government has stated that priority should now be given to staffing primary care teams to order to maximise the potential of service provision.

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