I thank the Cathaoirleach Gníomhach, Deputy Farrelly, for being in the Chair again. He is a regular on a Wednesday morning and it is much appreciated. I am surprised Deputy Daly is here because I thought he would be on his way to the High Court.
Sentiment score: 0.37
It is not a question-and-answer session. While I was walking across to the Chamber, I was struck by how ironic it is that I am the first ever Minister of State with special responsibility for mental health at Cabinet, and the Deputy is trying to remove me, while here he is today asking me to come forward and find a solution for him. I was just struck by how ironic it is.
Sentiment score: 0.00
I thank the Deputy for raising this matter. As he will be aware, operational responsibility for the delivery of mental health services at local level is devolved directly to the relevant HSE regional health area, RHA, which in this case is the HSE South West RHA, and across all areas. I am aware, of course, that the HSE always aims to work in partnership with all relevant stakeholders in the community in the design and delivery of mental health services to achieve positive outcomes for all. In relation to the issue highlighted by the Deputy, the HSE has provided an update that there was a requirement to identify a more suitable location for the National Ambulance Service in the region - and we all understand how important the National Ambulance Service is, especially in remote and rural areas - to better support its operational needs and enhance service delivery for people in the region. A potential space has been identified by the HSE alongside the mental health services in Cahersiveen. We must again go back to the point that it is extremely important that we can provide the whole continuum of health supports as close to home for people as possible. The HSE has informed my Department that there are no plans to relocate the mental health services at Cahersiveen to Killorglin. I am a little confused, though. Is the Deputy telling me he only represents the people of Cahersiveen and not the people of Killorglin? It is important to have mental health supports everywhere. I understand clarity on this matter is currently being addressed, with a senior HSE manager actively engaging with all relevant stakeholders to facilitate accommodation that meets the needs of both services. It is important we deliver both services. As the Deputy can appreciate, having a suitable location for the National Ambulance Service to be able to serve the people of Cahersiveen and the surrounding area is incredibly important, and it is my understanding this is being achieved without any changes to the location of community mental health services. From what I am hearing, though, I am also conscious that the services are in Cahersiveen and Killorglin is not served by this service. Perhaps this is something I need to look at. I want to deliver mental health services for all people regardless of what area of County Kerry they live in. The Deputy seems to be focused on just one area.
Sentiment score: 0.25
I am glad there are services in Killorglin because I would be disappointed if there were not. My understanding is that the HSE manager is actively engaging with all relevant stakeholders to facilitate accommodation that meets the needs of both services, the National Ambulance Service and, of course, the mental health supports, including the outpatient psychiatric facilities that support very vulnerable people. It is my understanding that while there are plans to locate a facility for the National Ambulance Service in Cahersiveen, that is not expected to result in community mental health services in the area having to move. I understand these services are well embedded in the community and I will continue to engage with the HSE in the Cork-Kerry HSE area. As the Deputy will understand, the HSE is working in partnership with all relevant stakeholders in the community in the design and delivery of mental health services to achieve positive outcomes for all and it would not be positive to close this service or to move it.
Sentiment score: 0.42
Gabhaim buíochas leis an Teachta. I thank the Deputy for his question about primary care provision for Rathdowney and Mountrath. I am taking this question on behalf of the Minister for Health, Deputy Carroll MacNeill. He raised a couple of matters: plans for succession in GP practices, challenges in rural Laois and the primary care centres in Mountrath and Rathdowney. I will do my best to address all of those issues. As the Deputy will be aware, timely access to GP and primary care services is vital for the successful delivery of our healthcare service. They are our first port of call. In regard to general practice, as he will also be aware, GPs are private practitioners, most of whom hold contracts with the HSE for the provision of public health services. Currently, almost 3,200 GPs hold at least one HSE contract, including roughly 2,600 GPs who hold a general medical services, GMS, contract for the provision of care. As private practitioners, GPs themselves determine the location they practice from, which can be difficult. However, in addition to undertaking to increase the overall number of GPs practising in the State, the Government is committed to ensuring that services are available throughout the country on an equitable basis, and in particular to supporting GP practices in rural and underserved areas. Significantly increased investment in general practice has been provided for under the 2019 and 2023 GP agreements. The agreements provide, among other things, for increased GP fees and practice supports, including a 10% increase to rural practice supports and increases to supports for staff capacity. We are conscious of the challenges in rural areas. The number of new entrant GP training places has been increased by 80% from 2019 to 2024, with 350 new entrant places available since last year. I accept they take time to come through the system, but there is a huge improvement. Furthermore, recruitment of GPs from abroad continues under the international medical graduates, IMG, programme, whose placement is targeted to underserved areas. Just recently, a new locum support initiative commenced, providing GPs in receipt of rural practice supports with access to a streamlined locum recruitment service. The initiative is initially focusing on supporting the more than 130 single-handed GPs working in isolated areas. That has just commenced. At present there are no GMS GP vacancies in County Laois. Where a vacancy arises, the HSE actively recruits for a replacement GP while providing for the continuity of services. Regarding the provision of primary care services, we are making steady progress on the development of primary care infrastructure in County Laois, which is currently served by primary care centres, PCCs, in Mountmellick and Portarlington with two further PCCs under development in Portlaoise and Rathdowney. I know the Deputy is particularly concerned with service provision in Mountrath and Rathdowney and I am happy to advise the following in their regard. It is intended that the PCC in Rathdowney will be delivered via the operational lease mechanism. In 2024, the HSE sought expressions of interest for this development and several valid tender submissions were received. The HSE is currently working through the tender assessments and internal approvals processes. Once this process is complete and all approvals are received, the successful tenderer will be notified which will allow for progression through the design and planning stages in 2025. The HSE Capital Plan 2025 includes funding to progress designs for the provision of primary care services in Mountrath. The HSE has advised that the current plans for Mountrath include the redevelopment of the existing Mountrath Health Centre site, including an extension and refurbishment of the existing building. This follows a reassessment of service needs, which indicated that the existing HSE-owned site could accommodate the service needs of the area. I expect the extension will be delivered much quicker than a primary care centre.
Sentiment score: 0.35
I thank the Deputy very much for raising the issue of rural GP practices in County Laois. He said a site has not been identified for a primary care centre in Rathdowney. That is normal. It is because it is commercially sensitive. If the HSE has not purchased a site, it could drive up prices. I have seen the exact same situation in Lismore in County Waterford, where a site was not identified in advance of the agreement being made on the operation of the lease mechanism. People on the ground probably know where the site is located.
Sentiment score: 0.19
But that is the reason that is the case. If the HSE does not own the site and it talks about where it is, straightaway, in the main, prices can go up, so there is a commercial sensitivity around it.
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The HSE also tells me that there are no general medical services GP vacancies in County Louth. As we know, when a vacancy arises, the HSE actively recruits. I have a couple of positives for the Deputy. The new locum support initiative has commenced, which provides GPs in receipt of rural practice supports with access to a streamlined local recruitment service. This initiative is initially focusing on supporting the more than 130 single-handed GPs working in isolated areas. I will bring his concerns back to the Minister and he will probably discuss with her the primary care centre in Rathdowney. It is positive that we are going to see an extension of the service in the existing primary care centre. The site is big enough for that to happen and the extension of services can happen much quicker. I know that from my own experience. The development of primary care infrastructure in County Laois is progressing. The Deputy Aird is correct that we want to bring the right care at the right time as close to home as possible. I will pass on his concerns to the Minister.
Sentiment score: 0.30