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13 Aug 2022

Future of major Primary Care Centre sparks heated debate with HSE and councillors

No reply from HSE on proposed Birr Primary Care plans, councillors told

Some of the Rectory Fields, Birr where it was mooted that the Birr PCC would be located

The future of healthcare provision in Birr sparked yet another strong and lengthy debate in the 'virtual' council chamber as Birr councillors received an update from the HSE on the delivery of a Primary Care Centre for the town.

Previously, there has been growing frustration and sheer anger over the stalled project for Birr and the Health Service Executive met with the councillors this week to provide them with an update on its provision in the town.

Following the HSE presentation, Cllr Clare Claffey outlined how the health service in Birr is “under pressure”. “Something has to be done now and a rush has to be put on this. Our GPs are at a crisis point so anything that can be done to help them and support them, has to be done now,” she remarked.

Cllr Claffey then voiced disagreement with the way the HSE contracts private developers to develop these “fundamental facilities”. “The situation where the HSE contracts private developers to develop these fundamental facilities is madness. I really don't agree with it. If the Government would fund the HSE to build this PCC using public money, it would possibly have been long built and the HSE would own it. The second best option for me would be a situation where the community, not a private developer, would benefit from the public private partnership which would have been the case with the Birr Rugby club. I wouldn't forget about what happened there and I will not bring it but I wouldn't forget.”

Later, she pointed out: “Now we are left in now is this shambles of a situation and while I don't agree with this solution, we are where we are and we need to move on. After the rugby club fiasco, the HSE then advertised for private developers, which was fantastic and we felt we were finally getting somewhere. Then without consultation, those tenders were cancelled in favour of the Rectory Field. Now this site has fallen apart and we are back to square one. I hope you can appreciate how frustrated we are.”

Continuing, the councillor stated: “I deeply appreciate the pressures on the HSE with regard to the Covid-10 pandemic but we need to focus on the future. We need commitment. We need a timeline to develop our centre in Birr asap. The people of Birr are worried that it is not going happen. That is what we hear. So, my questions are the same as it has been for the last number of years. Where is the PCC going? When it will be open? What types of diagnostic there? Will there be provision for an out of hours doctors service. Will you to commit to keeping us informed at all stages. We have one chance to get this right.”

Responding, Joseph Ruane, Head of Primary Care, HSE DML Midlands area, pointed out his objective in delivering the PCC was not economic and was about health service delivery. “ Simply, I will use whatever tools are available to me and are set to me within the Government set up to deliver what I can. My objective is a PPC,” he remarked.

While speaking at the meeting, Cllr John Clendennen pointed out that the HSE needed to provide greater clarity in relation to several matters. According to the councillor, the first matter relates to the process that led to more than a 12 month delay due to consideration of the Rectory Field as a potentially suitable site. “As per the briefing today, a minimum of three GP’s were required for Stage 2 evaluation of sites. This was the procurement process being undertaken and followed by the HSE, up to the point that a decision was taken to suspend the process and explore the Rectory Field as a potential site.”

“We need to determine how and learn from the decision that was arrived at to suspend the procurement process that was already underway, and explore the alternative possibility of the Rectory Field, prior to any consultation with GPs regarding their interest in the site & location and prior to any consultation (that I am aware of) with Elected Members regarding the availability of the proposed land for such usage," according to Cllr Clendennen.

The councillor also raised queries regarding the proximity of the current potential sites to the town centre Main Street and the current status of zoning under the County Development Plan are key criteria in identifying a suitable site under the Stage 3 process for the development of Birr Primary Care Centre.

“I am acutely aware of the confidentiality surrounding procurement and respect for those that have made submissions. I would be grateful if you could provide an estimated location for each potential site, rounded to the nearest 100 meters, in the best interest of confidentiality. In relation to the zoning, providing details of the current zoning status on each shortlisted site would provide clarification and reassurance that the land is zoned appropriately and mitigate the potential risk of planning permission difficulties relative to zoning,” stated Cllr Clendennen.

Cllr Clendennen concluded by stating the sheer frustration among the local community with the multiple prolonged delays for over a decade in the development of Birr Primary Centre Centre. ‘I acknowledge that this hasn’t always been due to the influence of the HSE, but at this point I firmly believe people deserve to know the reasons for yet another delay as well as the proximity and zoning which may impact on a realistic timeline for delivery of this much needed investment in local healthcare services, the councillor added.

Responding to Cllr Clendennen's questions, Niall Colleary, Estates Department of the HSE, confirmed the HSE weren't in a position to give details of the submissions yet. “In terms of the three submissions, we are not in a position to share this at the minute.... When we are at the time when we can share.... we will but currently we are not at the moment,” he replied.

Mr Ruane acknowledged the conversation around the Rectory field site. However, he said that the project has moved from there after the GPs communicated to the HSE in Autumn 2020 that for their own reasons they didn't “consider the Rectory Field a proposition for them” and it was here that the stage 3 process was triggered again by the HSE.

Cllr Peter Ormond welcomed the news that the GPs were on board with the project and there were three applicants looking to deliver a PCC in Birr. “ I think the timeframe is in place and we need to be looking at the steps and that we have this in place then we would know what steps are in place to deliver PCC in Birr,:” the councillor continued.

Mr Ruane replied: “ In terms of services that will be provided I am actually delighted to share that with you. The big thing is that all the HSE services that are in Birr will all be one roof. And, under this same roof will be the GPs.”

Cllr John Carroll outlined his continued frustrations at the situation. “I am very frustrated and if not a bit cynical on how the HSE has worked on delivering a PCC for the town of Birr,” he said.

“What should have been a very straightforward process, either provided directly or by a private developer, has ended up in a shambles. To tolerate this, over four or five years, to change land at a whim, regardless, has to be looked at carefully,” he stressed.

Cllr Carroll then questioned the HSE on their marking system for submissions made by developers, saying to “me nothing has been learnt from our past mistakes”.

He also asked in the new model being put forward, do the tenants not work directly for the HSE, do they pay rent to the HSE or is there an arrangement with the developer of the property.

The councillor also quizzed the officials about whether a timeline would be put in place, taking into consideration planning for the project, because “the last one there was no time line for it”. Later, Cllr Carroll asked who took the decision when the GPs didn't come on board to “reverse to the original model” for the project.

Mr Ruane pointed out to Cllr Carroll that without the GPs on board there is no PCC. “If the GPs are not involved the HSE will not be investing in a PCC.... When we are advertising for interest, different parties can go to the GPs, a third party and say I am looking to develop this and would you [the doctors] be prepared to move in. That is stage 1....... Ultimately then, it comes to the HSE to go through the criteria but our arrangement is with the third party and the third party then has distinct arrangements with the Gps or the other tenants of the PCC.”

Wrapping the meeting up, Cllr John Leahy, an Cathaoirleach of Birr Municipal District, stated: “In terms of where we are, I can see where you [the HSE] is coming from. I think there is a same bit of divide. I know that your staff put a lot of work into the rugby field project and it looked like that we rejected that. That was regrettable but we were looking at it in terms of the fabric of Birr. It proceeded to go ahead and you put the foot to the floor and went ahead again.”

“It is clear that you are committed to a PCC in Birr regardless of the hurdles. However, the Rectory Field is clouding it a small bit. It is quite clear today that ye have a process and a marking system and ye have GPs to bring along with ye and the Rectory field decision now makes sense. So, really truly and thank you for your time and effort as this is only one of many meetings.”

After the HSE left the meeting, the councillors took the decision to write to the Health Service Executive again to find out “exactly what the next stage is going to be” and to request they be kept informed on when the site selection will happen and when this information will be made available to them “We shouldn't have to hear it on the street,” Cllr Carroll re-iterated.

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