I propose to take Questions Nos. 861 and 866 together.
It is important to acknowledge the significant strategic reforms which have taken place since the previous examination of Primary Care Centres (PCCs). Notwithstanding COVID-19 restrictions, Sláintecare reforms have continued apace, leading to a changing environment for primary care services. Through the ongoing implementation of these reforms, initiatives such as the Enhanced Community Care (ECC) programme, has increased the provision of community healthcare services closer to home and reducing the pressure on hospital services, through the establishment of 96 Community Healthcare Networks and 60 Community specialist teams for older persons and chronic disease management.
Capital investment is also informed by the principles of Sláintecare, with infrastructure investment decisions aiming to support the overarching objective of ensuring that people can access the right care, in the right place, at the right time. For example, the Community Specialist Teams (CSTs) require appropriate facilities and to ensure the HSE provide for this, it has established the ECC Infrastructure Workstream of the Programme. The locations for the CSTs include dedicated spaces in Primary Care Centres and other healthcare facilities. As such, the scope of services that constitutes a primary care centre has been evolving.
Furthermore, the overarching purpose of the primary care centre programme is to provide modern fit-for-purpose healthcare facilities for the delivery of primary care services and to allow for closer coordination between primary care providers. However, increasingly, a number of primary care centres also provide facilities for other community-based healthcare services and health promotion activities. Therefore, the design and utilisation of PCCs is a function of local circumstances, population need and available resources.
However, the Department accepts the recommendation of the Comptroller and Auditor General’s Report on the Accounts of the Public Services 2024 to define a minimum scope of services. To this end, the Department has established a Project to review the PCC programme, with the following objectives:
• Definition of scope of services provided in Primary Care Centres (PCCs).
• Ensuring that PCC projects progressed yield optimum value for money – including inter alia infrastructure that meets the service needs of the population, regulatory requirements, adaptability, climate and are delivered in most cost-effective manner i.e. SHIF aligned and in line with Infrastructure Guidelines.
This recommendation will be addressed as part of that Project which is expected to be completed in Q4 2026.
I will also respond to the Parliamentary Question 57370/25 in relation to the two recommendations (15.1 and 15.2) of the Comptroller and Auditor General’s Report on the Accounts of the Public Services 2018, for which my Department was responsible. The HSE was responsible for the implementation of recommendations 15.3 and 15.4 and I have asked them to respond to you directly in their regard.
In relation to the implementation of Recommendation 15.1 of the Comptroller and Auditor General’s Report on the Accounts of the Public Services 2018, I trust that the above addresses this issue.
In relation to the implementation of Recommendation 15.2 of the 2018 Report, I wish to advise the Deputy that it was not possible to develop a fixed target for the delivery of the full network of planned Primary Care Centres given that several factors outside the control of the Department and the HSE can impact timelines for delivery. These included COVID-19 restrictions and market factors including market interest and capacity, statutory planning processes and construction inflation.
However, as outlined in its response to the Comptroller and Auditor General’s Report on the Accounts of the Public Services 2024, the Department accepts the recommendation to set an indicative timeline for the delivery of the PCC network, again also recognising that not all factors that will affect timelines for delivery are within the control of the Department and the HSE. In setting timelines, consideration will also need to be given to any update to prioritisation rankings as also recommended in the Comptroller and Auditor General’s Report on the Accounts of the Public Services 2024.
The Department has established a project to review the Primary Care Centre (PCC) programme. This recommendation will be addressed as part of that project. The next meeting of the Project Group leading this work is due to take place on 22 October 2025.
I can assure the Deputy that the delivery of the PCC network has remained a priority for my Department and the Government and a commitment to the delivery of the PCC network is reiterated in the Programme for Government (2025) which commits to “open more primary care centres and expedite the delivery of the existing pipeline to construction”.
In terms of healthcare infrastructure, I also wish to advise the Deputy that the Department published the Strategic Healthcare Investment Framework (SHIF) in August 2024. This is the first time an overarching framework has been set out for infrastructural investment in the public healthcare service. SHIF uses a four option Intervention hierarchy, underpinned by the principle of the Continuum of Care (Sláintecare vision) and contains six Investment Criteria to guide the development of proposals for capital funding in the public health sector. Application of SHIF will ensure that proposals developed and progressed are in line with national and sectoral strategic and policy objectives, service needs and provide optimum infrastructural solutions to support the provision of healthcare and delivery of value for money.
