Two key programmes aimed at expanding GP and primary care services have still not been funded, despite being promised by the Government well over a year ago.

This is one of a number of primary care reforms promised by the Government, including the planned roll-out of free GP care, that have been put into cold storage.

Health Minister James Reilly has yet to filll around 250 key posts for primary care teams and has also not delivered on a promise to set up a new programme where GPs, rather than hospitals, would treat around 100,000 patients with uncomplicated diabetes.

The €20 million earmarked for the 250 primary care staff, including public health nurses and physiotherapists, was announced in the HSE's service plan in early 2012 but due to the HSE's funding crisis, was not implemented last year.

The staffing expansion was to have been implemented this year, but as yet none of the 250 posts has been filled.

Separately, a major programme for the development of diabetes services in primary care has also been stalled.

Minister Reilly announced a programme to transfer the care of many diabetes patients to GPs at the Irish College of General Practitioners (ICGP) AGM in May 2012. 

The ICGP is about to meet for its 2013 AGM  but this programme, intended to improve the care of diabetes patients, has yet to be launched.

The recruitment of 17 specialist diabetes nurse posts for primary care as part of the diabetes care programme has yet to begin. These nurses were  to work mainly in the community as part of the establishment of integrated care networks linking primary and hospital care for the management of diabetes and other illnesses.

Asked about the 250 primary care posts remaining unfilled, a Department spokesperson told irishhealth.com that an allocation of €20 million had been set aside in the HSE's 2013 service plan to fund approximately 250 primary care posts.

"The posts will be filled using the resource allocation model, based on deprivation and need, which was developed by the HSE's National Primary Care Office and Health Intelligence Unit," the Department said.

The spokesman added that using this model, the HSE completed an analysis of the numbers and distribution of public health nurses, registered general nurses, occupational therapists, physiotherapists and speech and language therapists. 

"The analysis revealed considerable variation across the 17 Integrated Service Areas in ratios of health care professionals to population, and to population numbers in areas of high deprivation."

Minister Reilly said back in March that the 250 posts would be filled 'as soon as possible' after all the necessary documentation was sorted out.

The diabetes care programme involves transferring 100,000 patients with uncomplicated type two diabetes from hospital to GP care, providing patients with three GP check-up visits per year.

In addition, under the plan, patients with complicated type 2 diabetes were to have shared care between hospitals and GPs, while patients with type 1 diabetes would be cared for solely in hospitals.

GPs have warned, however, that such programmes for managing more patients with chronic conditions cannot work unless GP services are properly resourced to take on the  extra workload involved.

GP Chairman of the IMO, Dr Ray Walley said yesterday that what patients with long-term illnesses, such as diabetes, actually need is greater, structured resources at GP level to help them in the management of their chronic illnesses.

The March 2011 Programme for Government promised to provide for the transfer of a large amount of chronic disease management from hospitals to primary care.

The Government's decision to stall the plan to offer free GP visits to long-term illness patients has hit people with diabetes, who are included in the current Long-Term Illness scheme for free drugs.