Primary care list altered evening before launch

Two locations in Minister for Health James Reilly’s north Dublin constituency were added to a list of places chosen for primary care centres on the evening before they were announced by the Government, newly released documents reveal.

Further changes were made to the list including the addition of Ballaghaderreen, Co Roscommon, and Kilkenny just hours before the list of centres was announced as part of the Government’s stimulus package last July, the documents obtained under freedom of information show.

Last September, The Irish Times revealed that Swords and Balbriggan were added to the priority list announced by Dr Reilly as part of the stimulus package, despite the fact that they did not feature in a list of the top 30 locations drawn up by the HSE and his then minister of state, Róisín Shortall.

Swords, Balbriggan, Kilkenny and Ballaghaderreen all ranked outside the top 35 in the list of priority locations drawn up by Ms Shortall and HSE officials, which was weighted towards the most deprived areas of the country.

Swords ranked 130th in this list while Balbriggan ranked 44th. Ballaghaderreen, which was the subject of lobbying by two Government politicians, ranked 244th, while Kilkenny was ranked in 151st position.

The issue has proved hugely controversial for Dr Reilly and the Government ever since. Ms Shortall resigned in September and later described the addition of the two locations in north Dublin to her original list as “stroke politics”.

The documents reveal a flurry of last-minute changes in July after the Department of Public Expenditure and Reform (DPER) told the Department of Health for the first time that the locations would be published at the time of the stimulus announcement.

At that point, on July 16th, 33 locations were on the list. However, the Department of Health then drew up its “final list”. A memo sent to DPER at 8pm on that day – the day before the announcement – submitted a new list with Swords, Balbriggan and Oranmore added, and South Dublin removed.

The following day another memo from the Department of Health, marked “urgent – revisions”, stated that there were “changes to last night’s list”.

“There are now 36 locations. Ballaghaderreen is new . . . Kilkenny is new, Castlecomer is out, Oranmore is out,” the memo stated. It was sent at 11:55am, almost 1½ hours after that week’s Cabinet meeting started.

The documents do not show the rationale Dr Reilly employed in altering the original list, but the Minister has said he made his decisions based on a number of factors, including the likelihood of GP buy-in to the plans.

The official files also show that last month the secretary general of the Department of Health Ambrose McLoughlin asked its internal audit unit to “ascertain any connection that links the Minister and/or his four advisers in relation to the selection of the sites for the Balbriggan and Swords primary care centres”. This followed claims that a supporter of Dr Reilly owned the site of a proposed centre in Balbriggan.

Dr Reilly rejected any suggestion of impropriety in the selection of the site. He said this had nothing to do with him.

Fianna Fáil health spokesman Billy Kelleher said last night the new information posed serious questions for Dr Reilly and Tánaiste Eamon Gilmore. He said the Tánaiste told the Dáil there was documentation which could be sought under freedom of information on the background to Mr Reilly’s decision. Mr Kelleher said nowhere in documents released did this explanation exist. A spokesman for the Minister did not return calls last night.