Government plans to invest hundreds of millions of euro in primary care and mental health facilities are set to be deferred for up to three years. The Minister for Health, Mr Martin, announced last week that he had reached agreement with the Department of Finance to spend nearly €2.5 billion on healthcare capital programmes over the five years to 2008, writes Martin Wall.
The Minister for Health, Mr Martin, announced last week that he had reached agreement with the Department of Finance to spend nearly €2.5 billion on healthcare capital programmes over the five years to 2008.
However, internal Government documents show that the money will come on stream in such a way that the bulk will go towards the hospital sector over the next two years.
Large-scale funding for non-acute facilities, including investment in mental health services and the construction of primary care centres, the centrepiece of the Government's Primary Care Strategy, where GPs, nurses, midwives and social workers would all work under the same roof, would be put back until 2007.
The internal correspondence reveals that in the run-up to the agreement of the five-year capital investment programme, the Department of Health was both unhappy with the level of funding on offer and on the way the Department of Finance proposed to provide it in tranches of between €500 million and €600 million each year.
"Not only is the overall size of the envelope insufficient but the annual breakdown also presented us with serious difficulties," the Department of Health wrote to the Department of Finance in May.
The Department of Health complained that the capital budget was not "front-loaded" and did not take account of major commitments already entered into in the hospital sector which would consume a large part of the resources in the early years.
"A fundamental policy underlying the proposals is that equal investment should take place on the non-acute and acute sectors of the health service in the life of the programme. Because of the general level of major projects currently in progress in the acute sector, the major component of investment in the non-acute sector will have to be deferred until 2007 or 2008," the Department of Health stated.
A spokeswoman for the Department of Health told The Irish Times last night that talks with the Department of Finance on flexibility within the programme could allow spending on the non-acute sector to be brought forward.
She said that inevitable delays in hospital projects could also allow for money to be switched to be non-acute sector.
The spokeswoman added that spending on the non-acute sector would be maintained at current levels in the years immediately ahead and that "it would peak after 2007".
Over the life of the capital development programme, massive investment in funding will be made in the non-acute sector.
About €200 million will go to developing primary care with the same amount earmarked for mental health facilities.
About €118 million will be allocated for residential facilities for children with €100 million more to finance healthcare developments undertaken without authority by health boards.
A total of €165 million will go to developing facilities for the disabled with more expected in the forthcoming Budget in December.
A total of €500 million will be allocated for services for the elderly, particularly community nursing units, with half expected to come from public/private partnership agreements.
However, the revelations that large-scale investment in primary care is set to be delayed for a further three years is likely to infuriate GPs and their representative body, the Irish Medical Organisation.
Last July the Minister, Mr Martin, became embroiled in a public row with senior IMO figures over what they claimed was the Government's failure to implement its own strategy for the development of primary care.
This called for the establishment of 600 primary care teams - with family doctors, midwives, social workers and public health nurses all working from the same premises - over a 10-year period.
The president of the Irish Medical Organisation, Dr James Reilly, maintained at the time that "no realistic progress" had been made in implementing the strategy.