When this row broke out between James Reilly and Róisín Shotall it was obvious that there was deep dysfunction at the helm of our health services. That has been borne out with the resignation of Roisín Shortall.
In her resignation statement she said: "The public have a right to expect that decisions on health infrastructure and staffing will be made in the public interest based on health need and not driven by other concerns."
The Minister added 15 primary care centres to the original list of 20; two of the 15 are in his own constituency. He added new criteria to the criteria based on urban and rural deprivation. He claims these new criteria are : existing health facilities; GP to population ratio; Pressures on services, particularly Acute Services; Funding options, including exchequer funded (HSE) build or lease, and implementability of a PPP (size, site and scale). But he hasn’t told us how these criteria match the chosen locations.
And, clearly, he failed to satisfy his own Primary Care junior Minister Róisín Shortall that his criteria for choosing locations were correct. Again to quote Róisín Shortall in her Dáil speech last week: “Decisions on where staff are allocated and where primary care centres are located must be transparent and objective based on health need and no other consideration.”
There is another issue here which has got little attention. Minister Reilly is proposing to develop these centres by Public-Private Partnership only. In her Dáil speech Róisín Shortall said that primary care centres, just like schools, are essential public infrastructure and should be provided on the same basis. We agree with that.
Instead Minister Reilly is determined to continue the policy of his predecessor Mary Harney of developing primary care centres by public private partnership (PPP) only, thus allowing developers and vested interests in private healthcare – which he knows a little about himself - to have undue influence.
We have seen in the Comptroller & Auditor General report this week the millions of public money squandered on PPPs that have never materialised – including €4.1 million for radiation oncology that is now to be provided directly – a scandalous waste.
Sinn Féin asked Minister Reilly in the Dáil this week if he has an up to date cost benefit analysis of primary care centre development by PPP as against development by HSE - he failed to answer the question.
The bottom line is that the public need these primary care centres – and they need to be provided not in the interest of developers or GPs or anyone else but in the interest of patients.
