EIB invests €70M in 14 new Primary Care Centres – Varadkar & Lynch
- EIB board backs its first ever capital investment in Irish health facilities
- The Primary Care Centre PPP project is one of the first projects to be financed under the European Fund for Strategic Investment (EFSI) initiative established to support investment across Europe
- Services at 14 centres will include GPs, community nursing, dental, occupational therapy, physio, social work, speech & language, home help, mental health, counselling, nutrition
- Ministers urge other investors to consider investing in Primary Care Centres
- Another 20 centres being developed by Irish Government using non-PPP financing
Minister for Health Leo Varadkar and Minister of State for Primary and Social Care Kathleen Lynch have described the European Investment Bank’s decision to invest €70 million in 14 Primary Care Centres as a breakthrough for investment in primary care and great news for patients around the country.
The EIB said today it has approved a €70 million loan in principle to invest in the Public Private Partnership project for Primary Care Centres. This represents up to 50% of the finance required to deliver primary care centres at 14 locations in Ireland. The EIB will provide cheaper funding than would be otherwise available. The EIB Board has earmarked the Irish Primary Care Centres as the first projects in Ireland expected to benefit from financing under the European Fund for Strategic Investment, a new initiative seeking to support €315 billion of new investment across Europe and to be managed by the EIB.
Since March 2011, 44 Primary Care Centres have already opened through direct investment by the State either by direct build or by means of the operational lease mechanism. Centres are opening at the rate of one a month on average. However, to date none have been built through PPP.
This announcement from the EIB means that a significant element of funding – up to 50% – has been secured in principle for 14 sites, with work due to start in January 2016. Planning permission is already in place and depending on building size, some will be completed in around 12 months. Plans are also underway for a further 20 centres outside of the PPP project, using more traditional forms of financing, such as Operational Lease or Direct/own build.
Minister Varadkar said: “This is the EIB’s first ever investment in healthcare facilities in Ireland. It’s also our first ever PPP investment in Primary Care Centres. I hope it will encourage other investors to follow suit as the primary care centre delivery model offers a good fit for public and private financing.
“It’s fantastic news for patients and it’s a vote of confidence by the EIB in the Government’s strategy of investing in primary care facilities, and shifting the focus of healthcare away from hospitals and into the community. Patients at these new centres will benefit from the broader range of care services offered by local Primary Care Teams, similar to those already provided by the 44 Primary Care Centres which have opened since March 2011.”
Kathleen Lynch, Minister of State for Primary and Social Care welcomed the announcement. “Up to 95% of our healthcare should be delivered in the community. Developing our infrastructure to provide better facilities and ultimately better and safer care in the community has been a priority for the Government. This support from the EIB is validation of our policy. These centres will be home to services ranging from physiotherapy to speech and language therapy. It is a further step towards delivering the right care in the right place at the right time.”
All centres will house GP and community nursing teams and centres will offer extra services, including some or all of the following:
· Occupational therapy,
· Social work,
· Speech & language,
· Home help,
· Mental health,
The Centres will be open at least five days a week with extra hours at weekends and evenings for some services.
The Department of Health is the sanctioning authority for the PPP project while the HSE is responsible for managing and delivering the centres. The National Development Finance Agency acts as financial adviser and procurement agency.
Timeline for delivery
The Primary Care Centre PPP project is on schedule. Tenders from the preselected candidates, submitted in early February, are currently being assessed and analysed. The preferred tenderer will be selected shortly and the financial close is scheduled to be completed by late 2015. Construction will begin then on all 14 sites and it is expected that the primary care centres will be completed over late 2016 / early 2017 depending on the building size. Healthcare delivery will commence immediately thereafter.
EIB Finance Agreement
The finance agreement for the project has not been signed and is subject to negotiation. Financial and legal negotiations for the EIB loan are scheduled for completion over the coming months. Commercially sensitive financial information will not be disclosed.
Primary Care Centre PPP Project locations
The primary care centres will be constructed at the following 14 locations:
HSE Dublin North-East
Dublin north city – Summerhill and Coolock-Darndale
HSE Dublin Mid-Leinster
Wexford town, Waterford city, Dungarvan, Carrick-on-Suir
Limerick city, Tuam, Westport, Claremorris, Ballinrobe, Ballymote and Boyle
Primary Care Centres currently underway through PPP, Operational Lease or Direct Build
Primary Care Centres opened since March 2011
Rationale for Primary Care Centres
There is a growing demand for health care services which in the absence of enhanced primary care based treatment strategies, presents as demand on already constrained hospital resources with consequences for Emergency Department waiting times, pressure on hospital beds and delays in elective treatment.
The demand for health care is rising at a higher rate than the average in Europe with Ireland’s elderly population rising at nearly double the European average. Other factors such as the rise in obesity, chronic disease and advances in health technology are all further increasing demand for health services and as a consequence additional facilities and accommodation will be required.
The key component in local health care delivery is the Primary Care Team, and evidence shows that its effectiveness is increased when teams of professionals are co-located in appropriate accommodation. Enhancing and expanding capacity in the primary care sector is crucial to ensuring delivery of a preventative, joined-up approach to the management of the nation’s health and the modernisation of primary care delivery. Primary Care Teams support and promote the health and well-being of our population by making people’s first point of contact with health services easily accessible, integrated and locally based. Health care services available in the new primary care centres will include GP services, public health and community health nursing, a range of therapies – occupational, physiotherapy, speech and language therapy, and primary care social work. Based on verified service needs ambulance services, dental services, community mental health services, psychology and counselling services, nutrition and dietician services will be provided at designated locations.
Our ultimate goal is to ensure that people get care close to home and access to a greater range of health and social care services in their community. EIB investment will make this a reality for 14 rural and urban communities.
The built environment is a major determinant of health and wellbeing. Good design and development can support strong, vibrant and healthy workplaces and communities and help create healthy environments which should, where possible, include making physical activity easy to do and create places and spaces to support community engagement and social capital. The EIB announcement enables us and the preferred tenderer, when notified, to concentrate on delivering modern health care facilities to support best international practice in health care in developing care-pathways.
Investment in an enhanced, locally accessible health and social infrastructure will support easier access to modern, well-equipped public services. This PPP project, to be supported by European Investment Bank finance, provides an infrastructure delivery mechanism which is appropriate to and supports the delivery of integrated care through enhanced community services and focuses the more expensive acute hospital facilities on complex, specialist care.