Mr. Robert Watt:

I thank the Chairperson and members for the invitation to attend this meeting of the joint committee. As the Chairperson indicated, I am joined by my colleagues, Ms Treleaven, Ms McKenna and Mr. Tierney, as well as Ms Grace O'Regan and Mr. Bob Paterson.

We continue to make significant progress in transforming how we deliver health services in Ireland. We have taken measures that are having an immediate impact on the lives of patients and citizens, as well as working to deliver the foundational long-term change that is required in the health system. Critically, we have embedded Sláintecare reform across the Department of Health with the development of our programme board governance, whereby responsibility for implementation of key reform measures is now shared with our management team in the Department and our colleagues in the HSE's executive management team.

Yesterday, the Minister, Deputy Stephen Donnelly, published the Sláintecare Progress Report 2022 and the Sláintecare 2023 Action Plan, copies of which have been shared with members. The progress report sets out progress made in the Sláintecare implementation strategy and action plan. It includes a number of major milestones, a few of which I will highlight. Significant progress was made in establishing the necessary infrastructure to orientate care towards the provision of more services in the community. This is something we have discussed at previous meetings of the committee. Critical care capacity at the end of last year comprised 323 beds, which was a 25% increase over the level in 2020. Acute bed capacity has been increased by almost 1,000 beds since January 2020. At the end of December last year, there were in excess of 17,000 more staff working in our health service than there were in January 2020. They include additional nurses, health and social care professionals, doctors, dentists and associated colleagues. Expansion in eligibility, which is a fundamental element of Sláintecare in moving to a more affordable system for citizens, includes the highly successful introduction of a free contraception scheme, which was launched in September by the Minister and since expanded and, more recently, the abolition of inpatient charges.

The implementation of regional health areas, RHAs, is a significant reform of our health and social care services. We discussed this on the previous occasion, with members commenting that it is probably one of the most significant reforms ever undertaken in the public service. We need to manage this change carefully by phasing and implementing it in an appropriate way. I am pleased to advise that the RHA implementation plan has been shared with the Minister for his consideration. The draft was prepared by the Department and the HSE and has benefited from direct input from the new HSE CEO, Mr. Gloster, who will give his views on it presently.

At their core, RHAs will be the delivery units for most of the health and social care services provided throughout Ireland. They will be the key structures enabled to plan, fund, manage and deliver integrated care for people in their region. RHAs will be responsible for understanding the needs of the populations they serve and the delivery of effective services in response. Consistent with this, RHAs will have appropriate authority and control over key resources. The planned realignment of hospital groups and community healthcare organisations, CHOs, to the RHA geographies will be a priority action and has begun. This will provide a base from which to align the leadership and its wider teams. The new geographic teams will work to integrate care around patients and build clinical networks to support integrated services. RHAs are a means to deliver integrated care for patients that is planned and funded in line with local health needs. Of course, as we are all aware, they are not a panacea for all the challenges facing the system. They are, however, a necessary step towards providing better care for patients and more integration across the different elements of the health system.

In line with RHAs providing more integrated care for people at a regional level, the enhanced community care, ECC, programme of reform represents a population-based approach to the expansion of primary and community care at a more local level. Importantly, its integration with the acute hospital sector means it will provide health services closer to people's homes and reduce pressure on acute hospitals. It is expected that all community health networks and community support teams will be established and fully operationalised by the end of this year. Members may have seen the publication last week of the second report of the GP chronic disease management treatment programme in general practice, which focuses on the first two years of implementation, from 2021 to the beginning of 2022. This report showed that 91% of patients with chronic disease in the programme were not attending hospital for the ongoing management of their chronic condition, which is now fully and routinely managed within primary care. Our colleagues in the HSE have projected that the impacts of these networks and teams over a full year will enable between 16,000 and 21,000 emergency department avoidances, which is very significant in the context of the challenges facing the acute system.

The new public-only consultant contract, POCC, was introduced on 8 March. The contract, which will only permit holders to engage in public care within the public hospital system, is central to the delivery of the goal of universal, single-tier healthcare in Ireland. All new contractual offers made to consultants from that date will be on the basis of the new contract. All existing consultants are being invited to transition to the new contract.

The publication yesterday of the action plan for 2023 marks the final year of the strategy and action plan for 2021 to 2023. We are now looking to the future and to what the next strategy will look like, building on the success to date. We aim to develop a multi-annual approach this year and would very much welcome input from the committee into that process. This year will be another critical year for Sláintecare implementation. My team and myself, together with our colleagues in the HSE, are focused on delivering our key objectives and moving closer to the vision of Sláintecare to improve health and social care services for the people of Ireland. I am happy to take questions from members.