Malcolm Byrne (Wicklow-Wexford, Fianna Fail)
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Gabhaim buíochas leis an Aire Stáit.  She is familiar with this issue.  As she knows, I have raised it in the Seanad regularly and I have been in regular correspondence with the Department and HSE.  She will know that access to GP care is a huge issue, particularly in north Wexford and south Wicklow.  North Wexford, in particular, is one of the fastest growing areas of the country.  During the general election campaign, which we talked about before, the question of access to health services, particularly to GPs, was a major factor.  There are waiting lists for existing surgeries.  The surgeries provide a good service but they cannot take on any more patients.  The Minister of State will also be very familiar with the challenges around CAMHS and the children’s disability network team.

  While there are two existing surgeries, primary care centres, in 2010 or 2011 the concept of a new primary care centre for Gorey and north Wexford was advanced.  By 2018, even though several us had been raising the fact that there would be problems with a particular site, planning permission was granted for it.  In spite of the problems being raised continually, the HSE chose to continue.  By May 2020, as there had been no progress, I raised the issue as a Commencement matter in the Seanad and through correspondence, as the Minister of State will know.  The response to the Commencement matter at the time was that the Minister had been told a contractor had been appointed and, indeed, that construction would begin within 12 months.  Having gone from May 2021 to May 2022, when there had been no progress, I got the exact same answer.  I was told then that construction would commence within 12 months.  In November 2022, when it was no surprise that no construction had commenced, HSE correspondence stated it would be treated as a priority.  By November 2023, when we saw that there had been no progress on the priority for 12 months, I arranged a meeting with the then Minister, Stephen Donnelly, and HSE officials.  I always recall Mr. Donnelly's response and thank him for it.  He said that even in spite of the delays and cost overruns, the national children’s hospital would be finished quicker than the new primary care centre in Gorey.  I agreed with him.  This Minister, in fairness to him, intervened directly, such that in May 2024, 13 to 14 years after the original idea was conceived, the HSE relented and accepted that the existing site was not suitable.

  Regarding what we were being told was an immediate priority, expressions of suitable interest were finally advertised in November 2024.  I have been told, including in response to a parliamentary question and in correspondence I have had with the HSE from January, that following a discussion with stakeholders on the revised health service needs within the area, we would see the tender for the provision of a primary care centre advertised on the eTenders procurement platform in mid-quarter 1 2025.  I am not sure how anyone else would define mid-quarter 1 2025 but to me it is around now.  I would be grateful if the Minister of State could inform the House and, more important, the people in north Wexford, who have been waiting for the service for a long time, whether the tender is about to be advertised and whether we will finally see a primary care centre under construction, hopefully, by the end of this year or at least during 2026.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for his question.  This is my first time speaking to him as a Deputy.  Congratulations.

  The Minister for Health has asked me to thank the Deputy for raising these matters and for the opportunity to update the Dáil on these important issues.  The Government is clear that primary care centres are a very important part of the infrastructure needed for our health service. They provide a single point of access to healthcare services for patients in communities and are central to moving significant amounts of healthcare away from our acute hospitals.  Significant progress has been made in the delivery of primary care centres, with 179 opened to date.

  The need for a new primary care centre in Gorey was identified as part of the overall primary care centre development programme and had progressed under the operational lease model.  However, the selected provider encountered difficulties regarding viability of the project and, following engagement to attempt to resolve the issues, the HSE decided last year to withdraw from this process and re-advertise in order to progress a primary care centre for Gorey.

  The HSE conducted a review of the current and future service needs for the Gorey area, and it re-advertised the primary care centre on the eTenders procurement platform in November 2024, which is the first step in the procurement process. The second step in this process will involve publishing the next stage of the advertisement to eTenders before the end of this month.  I await the publication of the e-tenders because a bundle of primary care centres is included, one being in Lismore, in my area.  I have met the new regional executive officer of that area, Martina Queally, regarding capital projects in the south-east area.  She has a new team in place.  An analysis has been done of every single project and how each can be moved along as quickly as possible.

  The second step in the process will involve publishing the next stage of the advertisement on eTenders before the end of this month.  We will keep a very close eye on this.

  On the issue the Deputy raised regarding measures being taken to address the shortage of GPs in north Wexford and south Wicklow, under the GMS scheme the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders.  Where a vacancy arises in a practice with a GMS contract, the HSE becomes actively involved in the recruitment process to find a replacement GP.  As of December last, there were 21 GMS vacancies, which is less than 1%, and no vacancies in Wexford or Wicklow.

  A number of measures have been taken in recent years to increase the number of GPs practising across the country and to improve access to GP services for all patients. Annual intake to the GP training scheme was significantly increased by approximately 80% from 2019 to 2024, with 350 new entrant places made available from 2024.  Everybody will welcome this but I acknowledge that it takes several years for them to come on stream.

  Furthermore, the recruitment of GPs from abroad is ongoing.  As of October last, there were 114 international medical graduate GPs in practice, and funding has been provided to recruit up to 250 more GPs from outside Ireland this year.  Placement of these GPs is targeted at rural and underserved areas.

  The Minister wishes to assure the Deputy that this Government remains committed to both the continued development of primary care centres, including in Gorey, and to increasing the number of GPs practising throughout the country.

Malcolm Byrne (Wicklow-Wexford, Fianna Fail)
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I thank the Minister of State.  As she knows, I am always very happy when she is here answering questions, because of her honesty.  I wish her well in her role.  I very much acknowledge the 179 primary care centres that have been opened to date.  We have seen excellent primary care centres, in Carnew, Arklow and Enniscorthy, but my question is why the people of Gorey and north Wexford, one of the fastest growing areas in the country, should continue to be without a new primary care centre.  In the inter-census period 2016 to 2022, we saw in the Gorey electoral area population growth of 14%.  It is not fair that we continue to have to wait for progress on this matter, frankly because of HSE incompetence that means it did not take action in spite of locals and local representatives, including me, raising it over the years.  I am prepared to give the new team that is in place, which was mentioned by the Minister of State, some space to move on this, but I will not tolerate any further delays.

I will seek to regularly come into the House to raise this issue.

I appreciate the programme that has been made with regard to additional recruitment of GPs and the training programme. This is very welcome. I get the point about the GMS scheme, but this is even about people wanting to be able to access a GP privately. It is not uncommon for somebody to be told they will have to wait three, four or five weeks, or longer, to access a GP in Gorey, and the existing GP surgeries cannot take on any new patients. We therefore see large numbers of people moving into the area without having access to a GP, and it is a really significant problem.

Mary Butler (Waterford, Fianna Fail)
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The need for a new primary care centre in Gorey was identified as part of the overall development programme and had progressed. The Deputy mentioned HSE incompetence, but the selected provider encountered difficulties regarding viability of the project. More than one project was involved; I know that for a fact. This is under an operational lease model. It is a new model the HSE is undertaking to deliver these primary care centres. In fairness, as regards the fact that the selected provider encountered difficulties regarding viability of this project and others, it was back to the drawing board and it had to be retendered before Christmas. I was as frustrated as the Deputy when I heard this news. Quite a few primary care centres in the south east are included in that. We will keep a very close eye to make sure that it is up on eTenders before the end of the month. We will all welcome that progress, seeing as there are two Deputies and the Ceann Comhairle from the south east in the room at the moment.

I reiterate that every effort is being made to provide as many GPs as possible. From 2023 to 2027, between 1.5 and three GP graduates will onboard for every expected GP retirement, and that is really positive. However, I take on board the point the Deputy made. There are some areas with significant challenges, huge waiting lists and people having to wait longer for GPs than they ever had to do previously, and it can be very frustrating. It is difficult for people when they move into a new area. If they do not have a medical card, they can find it hard to become part of a GP practice. We are aware of that. The only way we can resolve it is by having extra GPs, and please God they will come on stream as soon as possible.

I thank the Deputy. I have no doubt I will be back in here again to answer about Gorey primary care centre.

Verona Murphy (Wexford, Independent)
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I hope not, Minister. I thank Members.