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Irish government to revamp primary care

BMJ 2001; 323 doi: (Published 08 December 2001) Cite this as: BMJ 2001;323:1323
  1. Doug Payne
  1. Dublin

    The Irish government has released details of an ambitious and radical plan to revamp primary care services.

    The primary care scheme, which is part of the overall seven to 10 year national health strategy, aims to integrate all strands of primary care—including GPs, nurses, midwives, and social care professionals such as dietitians, counsellors, and physiotherapists—to reduce pressure on the hospital system.

    So called “one stop service” units are to be created throughout the country, each serving a population area of 3000 to 7000. Twenty to thirty such units are to be set up by the end of 2003, with 400–600 by the end of 2011. The number of professionals in each primary care team will depend on its location and the size of population it serves.

    The minister of health, Micheál Martin, said there would be a primary care task force in place by January that would also determine the location of primary care units. He also said that a new national out of hours GP service would be in place by the end of 2003, to be supplemented by freephone and internet access to primary care information. People would be encouraged to enrol with a primary care team and with a GP within that team—perhaps by 2005.

    The Department of Health's plan also foresees an electronic records system, costing £Ir50m (£40m or $57m), for all patients by the end of 2008. To support this part of the plan, each team would require a £Ir60 000 start-up investment for information technology facilities.

    “A small shift in the number of people referred by their GP to a hospital could have a dramatic impact on the numbers being seen in outpatients and accident and emergency,” Mr Martin said at the launch on 28 November. “Developing primary care will provide a means whereby those conditions which require referral can be prevented or identified earlier. It will also allow many of those who are seen in the outpatient system to be discharged back to the care of their GP.”

    The Association of Irish Nurse Managers called the team care plan “a seismic shift in the focus of initial health care.” The Irish Medical Organisation and the Irish College of General Practitioners also welcomed the new £Ir1.5bn strategy, which is to be implemented “in selected areas during the coming years,” according to the minister. It will require 500 additional GPs and 2000 nurses and midwives. The medical organisation went so far as to congratulate the minister for a plan that “firmly establishes general practice as the cornerstone of primary care services in Ireland.”

    According to the plan, however, “the timetable is contingent on availability of resources, partnership with the service providers and the learning derived from the implementation projects.”


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