And 40,000 houses.

I ask the Deputies to have respect for their colleague.

I hope the Minister and I can agree we need more GP care in this country and, in particular, in Dublin's north inner city in the constituency we are both elected to represent. My question to the Minister today is what he is going to do as Minister for Finance to stave off the closure of the GP Care For All practice in Summerhill in Dublin 1. As he and I know, this GP care practice is run by a medical charity. It directly employs GPs because no one else has been willing to set up a GP practice there. This is because the partnership model of privately owned GP practices would not work there.

The double taxation issue with regard to the GP practice arose in early 2024. It has already been well aired. The reality is that in 2025 we have had no progress. We have had unworkable solutions from the Department of Health. Two of these solutions were vetoed by the HSE. We have a farcical situation whereby the HSE has paid for legal and accountancy advice to be given to the Department of Finance and we have heard nothing back from the Minister's Department, the Department which instigated this mess in the first place.

Last November, in the middle of the election campaign, the former Minister for Health, Stephen Donnelly, went on RTÉ's "Prime Time" and said there was no way we would let this practice close. He said not only would it not close but that it would be used as a pilot project and a practice would be opened in Finglas. What is happening here? The five GPs tell us they cannot stay open past June if the double income tax payment issue is not resolved. If it does close, the impact will be devastating, and not only for the 2,600 patients in the practice. This is not just about Summerhill. It is about Finglas, where there are 14 GPs on the GMS schemes in east Finglas and no GP in west Finglas. It is about the dire shortages we see throughout the country in terms of timely access to GP care. It is about the impact of these shortages, including delayed diagnosis, the deterioration of people's conditions, increased hospitalisations and premature deaths.

The reason we have these shortages is the private system of GP care in Ireland. Time and again when we speak to GP trainees they tell us they want to work as clinicians and do not want to set up businesses. At present, the only way we can ensure GP care in some of the most socially deprived parts of our communities is for the HSE to recruit directly or to let medical charities continue in operation. We need to join the dots. Even The Lancet this week pronounced on how we need to change. It devoted an editorial in its March edition on how Ireland is an outlier with a private system of GP care, how our inaccessible primary care system places tremendous strain on hospitals and how this is a political choice.

Thank you, Deputy.

I have to say this is a double taxation issue and the buck stops with the Minister for Finance.

Thank you, Deputy. The time is up.

I ask the Minister what he is going to do to save this medical charity and other medical charities throughout the country.

I thank Deputy Sherlock for raising an issue with which I am familiar. In particular I recognise the work that GP Care For All has done, and the person at the heart of it, Amanda Farrelly. I was hoping to meet them myself tomorrow but another Government commitment has got in the way. I am well aware of the importance of the work they do and the value of the service. While I very much welcome and acknowledge Deputy Sherlock's right to raise this here, making points such as that the Department of Finance is at the heart of this mess does a disservice to the complexity of the issue. I hope a bipartisan approach to try to correct it can play a role.

I know Deputy Sherlock is aware the HSE wants to recruit GPs who can work directly for the public service. I know she is aware of changes that have already been made to tax legislation to try to deal with this issue. Unfortunately, changes that were made by my predecessor, Deputy Chambers, to deal with an issue that had been raised have not made the progress we had hoped. I hope and know Deputy Sherlock is aware of how much work has gone on in the Department of Health and the Ministry of Finance to try to identify options for dealing with this issue, which so far have not yet had the success we would want.

The very heart of this issue, as Deputy Sherlock well knows, is the relationship that is in place from a contractual perspective between GPs and the HSE, which goes back to legislation from 1970, and the tax consequences of this which mean that, as a matter of law, income under a GMS contract belongs to the GP who entered into the contract with the HSE. This assessment was confirmed by the Tax Appeals Commission's determination in January 2022. This is the background to the issue.

There are officials and politicians of goodwill who have worked to try to find a way of resolving this. I, as the Minister for Finance, in conjunction with my colleague the Minister for Health will continue to do what we can to try to make progress on this issue. If goodwill alone could have solved this issue it would have happened and Deputy Sherlock knows this is the case. She knows work has happened on it. I and the Minister, Deputy Carroll MacNeill, will prioritise this issue. We will look at the options that are there. Certainly from a tax perspective I will engage on this issue and see whether steps can be put in place. I look at the progress we have made in opening a primary care centre in Summerhill, what it means for those on Sean O'Casey Avenue and in the surrounding communities and the difference it is making from a health perspective. I look at the great work these GPs are doing and Deputy Sherlock is raising this issue on their behalf. I know the impact and the role they play in supporting the health of their patients.

Thank you, Minister.

We will do our very best on this issue and I thank Deputy Sherlock for raising it.

I thank the Minister. There is obviously goodwill on all our parts towards the practice but what I am not hearing today is a sense of urgency with regard to this situation. The chair and the practice manager are in the Public Gallery and they are waiting to hear answers from the Minister. The reality is that the 2,600 patients in the practice include some of the most vulnerable people in our community, as the Minister and I know. The practice is turning away ten to 15 patients per day. The stalemate at present is preventing the opening of a further list in this community. With regard to the plans in Finglas and other parts of the country, there are people who are not accessing GP care at all. I ask the Minister to bring a sense of urgency to this.

The reality, as we understand it, is that the changes instigated in the 2023 Act were designed to try to tackle corporates taking over private GP practices. As I understand it, they have found a loophole, and yet the people who should not be affected by these medical charities are being affected. That is wrong.

Deputy Sherlock knows we are treating this issue with urgency. She knows that. She knows the Minister is and she has acknowledged that to me. She knows we are working on it. The Deputy does the issue a disservice by suggesting otherwise. I ask her to please acknowledge, as I have done, that if this was an issue that was simple and that could easily be dealt with, we would already have done so.

We have acknowledged that this is a complex issue. Unfortunately, that complexity means that a group of deeply committed healthcare professionals, who have decided to provide services in communities that the Deputy and I are lucky enough to represent, are now facing the vista of them not being able to continue that work, and what is suffering or could suffer from that is the health of those we are doing our best to stand by.

What I have done is outline the work that has already happened with regard to this, which I know the Deputy is aware of. We have put in place different options to try to resolve the issue but I know they are not leading to the outcome that I want. If I was in a position to outline a detailed solution to this today, that detailed solution would now be implemented, and what we will do is continue to work on this issue and do our best to find a solution to it.