Private sector increasingly dominating network of primary care centres

The delivery of healthcare in the community through the creation of a network of primary care centres is increasingly dominated by the private sector, according to a study.

The result is a more commercialised network subject to the financial risks associated with public-private partnership, the study by UCD geographer Julien Mercille asserts.

It has long been government policy to move most healthcare out of hospitals and into the community. In 2001 a new strategy envisaged the creation of primary care centres housing doctors and other health professionals throughout the country.

This process was delayed for many years by resource issues, political controversy and resistance in some areas among doctors. In recent years, however, the number of new centres opening has increased.

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By the end of this year 140 primary care centres will be operational, according to the study published in the International Journal of Health Services. The HSE estimates 542 centres will be required to deliver healthcare across the State.

Some 35 per cent are publicly-owned, 55 per cent operate on leases with private landlords and 10 per cent are public-private partnerships.

Before 2009 primary care centres were delivered by traditional public procurement, but since then private delivery methods have been prioritised.

Economic downturn

Dr Mercille says a number of factors lie behind the growth of private sector involvement in primary care centres. The economic downturn limited the State’s ability to spend on new centres, the government and EU have actively support public-private partnership and global investors have recently entered the Irish primary care centre market “because it offers relatively high profit opportunities”.

He says no private healthcare companies operate in public centres and those operated by public-private partnerships, and leased premises often include private for-profit healthcare companies such as pharmacies, diagnostics firms and consultants.

Currently one in five primary care centres does not have a GP.