Health strategy: The Government will not provide tax incentives to encourage the development of the planned network of primary care centres around the State.
The proposed centres, which are essentially one-stop shops where patients can access the services of GPs, social workers, physiotherapists and other healthcare professionals under one roof, are a key element of the Government's Primary Care Strategy published in 2001.
It has been estimated that the bill for the provision of these facilities could reach €1 billion and both the current Minister for Health Mary Harney and her predecessor, Michéal Martin, had indicated that the private sector would have to be involved in the project.
Mr Martin had proposed last autumn before he left office that the Government should consider the provision of tax breaks in this area as a means of stimulating private sector investment. Mr Martin had unsuccessfully sought to encourage the Department of Finance to consider tax incentives in this area in previous years.
However, priority was given to the development of nursing homes and private hospitals.
GPs as well as groups of business people and developers had made representations to the Government in recent months supporting the provision of new tax incentives in this area.
However, sources close to the Department of Health said in recent days that there would be no tax breaks for the development of primary care centres contained in the Finance Bill which is currently going through the Oireachtas.
The decision is likely to anger doctors' groups such as the Irish Medical Organisation (IMO) which has already strongly criticised the low level of State investment in primary care services and the lack of urgency in implementing the 2001 strategy.
Complaints by doctors that the Government was not implementing the Primary Care Strategy led to a major public row between Mr Martin and leaders of the IMO at a press conference in Government Buildings last summer.
The Government has so far spent around €16.5 million in capital and revenue funding on the development of primary care teams on a pilot basis in various parts of the country.
However, The Irish Times revealed last autumn that large-scale State funding on the development of the primary care centres had effectively been deferred until 2007 and 2008.
Exchequer funding for the new centres will come from Government's €2.5 billion National Capital Programme for Health which runs from 2004 to 2008.
However, due to the way this money is being allocated by the Department of Finance, priority for the first few years will be given to meeting the costs of building and equipping several new hospital projects around the State.
The Department of Finance has decided that the money should be drawn down in tranches of around €500 million a year for five years.
However, in the initial years the Department of Health has to meet the costs of contracts already entered into for major secondary care developments such as the new children's hospital to replace Temple Street on the site of the Mater in Dublin. At more than €400 million, this will be the most expensive healthcare project so far in the history of the State.
The decision that there will be no new tax incentives for primary care centres comes just one week after the Tánaiste told the Dáil that the Government would not, by itself, be able to fund the cost of the development of the primary care centre network.
Ms Harney said it was clear that the existing network of community health centres and general practice premises was not adequate to meet the needs of the primary care teams as set out in the strategy document.
However, she said that "to ensure that appropriate facilities are developed on the required scale, resources other than those of the Exchequer will be required".
According to Ms Harney this was in line with the historic practice whereby there had been a mix of public and private facilities provision, with, for example, general practitioners in many cases funding their own premises.
