Gary Gannon (Dublin Central, Social Democrats)
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There is a significant problem developing in my community. The GP Care For All service in the primary healthcare centre in Summerhill is a fabulous service. I knew what existed at that location before in terms of GP healthcare; what exists now is a beyond a world of difference. GP Care For All is a charity-run model. Doctors are salaried. Most important, those who avail of the service are some of the most vulnerable in the community. They have no idea that it is a different style of GP practice from anywhere else - why would they? The doctors are fantastic, the service is amazing and the environment is everything they would need in a clinical setting. As a result of some financial quirk of an anomaly, however, the service is threatened.

It requires an amendment to the finance Bill to change the tax treatment of charity-run GPs such as GP Care For All. A similar measure was adopted last year by the then Minister for Finance, Paschal Donohoe, who is a constituency colleague and would be aware of this service. He brought an amendment through to save a different type of practice relating to business partnerships for GPs. That amendment was brought through for private GPs in a business partnership and we are asking for something similar.

I do not want to see that practice go. It is incredible. The GP Care For All service is a model that should be replicated the length and breadth of the country. There is one in Summerhill and one was due to open in Finglas West. Others should be planned wherever there are vulnerable communities or hard-to-reach GP services. If this goes, we lose not only a valuable service but an incredible opportunity.

I would be surprised if the Minister of State in her position were not aware of the work of GP Care For All. I am surprised this issue has dragged on for so long. It requires an amendment to the finance Bill. That should be done with some degree of urgency. The opportunity for it is nigh. The service is in consistent engagement with the Department of Health and the HSE. It has sought a formal statement from the Department of Finance but, at this point, no such statement has been forthcoming.

I appreciate it is not the Minister of State's exact domain but I would like to hear her statement and respond afterwards.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising the Summerhill primary care centre and GP Care For All. GP Care For All is a registered charity based in the Summerhill primary care centre that provides GP services to the local area. Its aim is to deliver care to patients living in areas of social deprivation, providing access to GP services where it would otherwise be limited.

I assure the Deputy that GP Care For All and the care it provides to the community and its more vulnerable members is highly valued by the HSE and the Department of Health. Delivery of GP services in the area would be very difficult without the operation of GP Care For All. The Minister for Health, his Department officials and the HSE are aware of the current challenges facing the organisation. The core issue relates to the contractual arrangements between GPs and the HSE for the provision of services under the general medical services, GMS, scheme. Under the scheme, the HSE contracts individual GPs to provide GP services without charge to medical card and GP visit-card holders.

In general, a GP who holds a GMS contract is, under tax legislation, the chargeable person as regards income arising under the contract. I think that is what the Deputy is referring to.

Gary Gannon (Dublin Central, Social Democrats)
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It is.

Mary Butler (Waterford, Fianna Fail)
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The administration of taxation is a matter for the Department of Finance and the Office of the Revenue Commissions. While the local HSE maintains a very positive relationship with GP Care For All, I have been advised that Department and HSE officials have had two meetings with GP Care For All management regarding the current challenges as well as numerous phone calls and written communications on the matter.

These discussions have focused on identifying solutions to the challenges faced by the organisation that are within the purview of the Department of Health and the HSE, which will allow GP Care For All to continue to deliver its services in a way which is sustainable and ensures compliance with all relevant legislation and regulations.

Engagement between the Department of Health, the HSE and GP Care For All is ongoing. It is a priority for the Department and the HSE to ensure that GP Care For All can continue to deliver the important services it provides. That is as much as has been provided in this particular report but my understanding is that a lot of interaction is going on at present.

Gary Gannon (Dublin Central, Social Democrats)
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I thank the Minister of State for the response. This is where my frustration and that of the practitioners comes from, as well as, most importantly, the concern of the multitude of different communities and mostly vulnerable communities that avail of that service. Without question we all accept the substantive work that GP Care For All does. We are all in absolutely no doubt but that the service is and can be transformative. I also have had meetings with GP Care For All and with the HSE. Many people have been taken aback by the breadth of work, the fluidity of the practitioners, the manner in which salaried GPs are there and contributing massively. Then there is the risk that it is going to close. While I appreciate the HSE understands its importance and through the Minister of State's own engagement she clearly understands its importance, we can also appreciate that if this issue does not change then that service will close. I do not submit Topical Issue matters that are flimsy. This is something we do because we have an expectation of urgency. I really need someone from the Department of Finance to tell me - in addition to all these discussions - what we are going to do. This is a House where laws are changed, laws are enhanced and where things are made better.

We have a service that works and there is an acknowledgement from the HSE and the healthcare system that this works. Yet we have ongoing discussions. There was an amendment, which I badly explained in my last presentation, and the GP business practices had something similar in terms of their tax implications, which is a simple amendment to the Finance Bill to change it. My colleague, Deputy Róisín Shortall, who is infinitely more knowledgeable in the area of health than I or many other people will ever be, has made the exact same suggestion. We need an amendment to the Finance Bill that alters the tax arrangements for the salaried GPs in the GP Care For All service so we can keep it and have it thrive and be replicated the length and breadth of the country, because it works.

Mary Butler (Waterford, Fianna Fail)
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I understand the Deputy's passion on this because at the end of the day, vulnerable people are receiving this care and they need to continue to receive the care. I believe that everyone is in agreement of the value of the services provided by GP Care For All to persons living in areas with social deprivation and all recognise that the organisation is essential to delivery of GP services.

The Department of Health is fully aware of current challenges faced by the organisation and is currently engaged with GP Care For All management on the matter. The Department has met GP Care For All and both sides are exploring possible solutions to those challenges, as discussed at their meetings. Sometimes the challenges relate to the Department of Health only but this is a wider piece. The continuation of the GP Care For All service is a priority for the Department of Health and the HSE. They are actively working with GP Care For All but I will follow up on this. I will follow up on it, if not this evening then first thing in the morning. I am not sure what the situation is in respect of the Department of Finance but everybody needs to see a workable solution here and we need to make sure that GP Care For All is still provided to the most vulnerable people who need it.