Catherine Byrne (Dublin South Central, Fine Gael) | Oireachtas source

I move amendment No. 2:

In page 6, between lines 35 and 36, to insert the following: "(b) in subsection (2)—

(i) in paragraph (a), by the substitution of "subsection (1)," for "subsection (1), and",

(ii) in paragraph (b), by the substitution of "functions, or" for "functions.", and

(iii) by the insertion of the following paragraph after paragraph (b):

"(c) subject to section 10AA(1) and (3), one or more than one health needs assessment (within the meaning of section 10AA(8)) to be implemented by the Executive in the service plan prepared in accordance with section 31.".".

Amendments Nos. 2 and 4 relate to health needs assessments. I thank the committee for facilitating discussion on these amendments. Health systems across the world are faced with rising demands for health care, increasing inequalities in health and limited resources to address these needs. If, as envisioned in the Sláintecare report, we are to improve population health planning and deliver more effective and integrated care, we will need to premise the design and delivery of new models of care on best national and international evidence and make appropriate use of all of the available data sources which can inform service planning and provision.

A health needs assessment is a systematic method of identifying unmet health and healthcare needs of a population and identifying the changes required to meet those unmet needs. The intention of the health needs assessment amendments is to provide for a more strategically targeted, beneficial and ambitious approach to such studies than is currently the case. Their use will ensure that the health system becomes more responsive to the dynamic and changing nature of our population's healthcare needs and ensure, as proposed in the Sláintecare report, that addressing the social determinants of health becomes a guiding principle in the design of our healthcare system.

The amendments provide for ministerial directions to be issued to the HSE which will require it to conduct evidence based scientific, statistical or other systematic analysis with a view to bringing about change beneficial to the health of the population. The scope and timeframe for conducting any such assessment will be included as part of the direction. Provision is also made for the development of guidelines which will inform how assessments are to be conducted and for supplementary directions to be issued in circumstances where the content of an assessment report may need to be improved prior to publication. The findings of assessment reports will be published by the HSE on its website.

The purpose of amendment No. 2 is to include provision for the issuing of ministerial directions for the conduct of health needs assessments within the ambit of section 10 of the Health Act 2004, which covers ministerial directions more generally.

Amendment No. 4 provides for a new section to be included in the Bill, which inserts a new section 10AA in the Health Act 2004, addressing the details of how the ministerial directions relating to health needs assessments will operate in practice, the implementation of such directions and related matters. Subsection (1) provides that a direction relating to health needs assessments that is issued by the Minister must include details as to the specific requirements to be taken into consideration by the HSE when conducting the assessments that are the subject of the direction. Subsection (2) provides details as to the types of requirements that might be taken into consideration for inclusion in a direction. Subsection (3) provides for consultation by the Minister with the Minister for Public Expenditure and Reform and any other person, as appropriate, prior to issuing a direction. Subsection (4) provides for the submission of a report on the findings of a health needs assessment by the HSE within such timeframe as the Minister may specify within the direction. Subsection (5) provides for the approval of any such report within a period of one month after its receipt or for the issue of a supplementary direction to address any defects in the content of the report after it has been submitted. Subsection (6) provides for publication of the report on the Internet. Subsection (7) provides for the development of guidelines by the Minister with a view to facilitating the conduct of health needs assessments by the HSE. Subsection (8) defines the term "health needs assessment" for the purposes of the new section.