SWORDS AND Balbriggan were on a high-priority list for primary care centres identified by the Fianna Fáil government in 2007, Minister for Health James Reilly told the Dáil.
Defending his controversial inclusion of the two locations in his constituency on a list of potential locations, he said that because of the change in criteria from 2007 with an increased weighting given to deprivation, they both lost out. They were “swept from high priority to low priority. Under the original priority system, both would have been in the top 35”.
Dr Reilly insisted “the realities haven’t changed but the weighting made it look as if the realities had changed”.
He said Balbriggan was an area of high unemployment with no existing primary care centre. Swords had a population of 48,000, no primary care centre and no direct public transport link to a hospital.
The Minister paid tribute to former minister of state Róisín Shortall, who resigned on Wednesday. He wanted to “put on the record my gratitude to minister Shortall for her commitment to primary care” and her work on the issue of alcohol abuse, which he hoped would in particular be carried on by her successor Alex White.
But Fianna Fáil spokesman Billy Kelleher, referring to Ms Shortall’s statement in the debate on the no-confidence motion on Dr Reilly, said her concern was that decisions would be made “based on public health need and not driven by other concerns”.
Mr Kelleher said there were “quite clearly other concerns”. He said the most obvious route would have been to go to the next 15 on the list, and not change criteria halfway through. He added that public-private partnerships (PPPs) “quite clearly confer commercial advantage on people”.
Dr Reilly said he “decided in consultation with my department officials and Government Ministers to go beyond the initial mathematical model”. He said the number was too small and “we needed at least 35”.
The Minister said Ms Shortall used three criteria. “I used additional criteria.” These included “existing health facilities, GP to population ratios, pressures on services, particularly acute service, funding options and implementability of a PPP”. He reiterated that he stood over his decision, and insisted the manner in which it was made and the criteria were transparent.
Dr Reilly told Mr Kelleher “I accepted the first list of 20 prospective centres presented by minister Shortall.” He said, however, that the advice of the HSE and the Department of Health, based on their experience of PPPs, was that “if only 20 were chosen, considerable slippage could take place and the health system could lose a badly needed investment”. He also said the HSE’s record in delivering PPPs was poor.
In a letter to Ms Shortall on July 25th he wrote that “a very strong consensus emerged at Government level that identifying 35 locations would stimulate and encourage wider interest”.
