Only a third of proposed primary care centres have been completed and the rest could take up to 20 years to open at the current rate of completion.
The state's spending watchdog outlined the slow and disjointed progress for the centres as HSE chiefs faced questioning before the Dáil Public Accounts Committee on spending and health projects.
Comptroller and Auditor General Seamus McCarthy reported that a total of 127 operational primary care centres were functioning as of March this year, stating: “In simple numeric terms, this is just over one third of the network originally envisaged. A target time frame for the delivery of the primary care centres has not been set.
"If delivery continues at the current rate, it is estimated that it will take at least a further 20 years to develop the full network.”
The Department of Health has a target of 350 locations for centres around the country with 500 primary care teams.
Mr McCarthy noted how there was no definition of how such centres operated, nor how they should be staffed and there was no central information system for primary care units in the HSE.
“We sought information from the HSE on the size of the existing centres, the staff deployed to each, the nature of the services provided, the procurement method and the cost.
This type of information was not available centrally. Information in relation to the premises and their procurement was compiled manually and from multiple sources across the HSE.
"We could not get a clear picture of the range of services offered,” the C&AG said regarding his recent review of the centres.
A ranking of centre locations and priorities had also not been revisited by the HSE since 2012, PAC TDs were told, despite population and economic changes.
Fine Gael TD Kate O'Connell agreed there were "very loose" plans around centres while HSE CEO Paul Reid explained that different models, including public-private partnerships and leases, were being used to set up such facilities.
Another 77 primary care centres are also set to be opened over the next year.
Meanwhile, the HSE has confirmed that the extra million hours of home help will only reduce by half the backlog for households seeking help.
A HSE official told PAC that it would take of the order of two million extra hours to give the 7,000 people on waiting lists the six hours of help a week.
PAC chairman Sean Fleming said: “The point is the Budget recently provided an extra million home help hours. What that appears to me to be saying is that will actually only deal with half of those who are already approved and are currently wait-listed.”