Terence Flanagan (Dublin North East, Fine Gael)
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Question 720: To ask the Minister for Health his priorities for the year ahead and the achievements from the Programme for Government to date; and if he will make a statement on the matter. [36206/12]

James Reilly (Dublin North, Fine Gael)
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The HSE is facing a significant challenge in 2012 given the need to set expenditure levels within the parameters of the National Recovery Plan. The health sector has experienced a significant reduction over the last three years, both budgetary and staffing. Notwithstanding these constraints the following has been achieved:-

· the HSE has operated the Croke Park Agreement very effectively, with over 3,500 staff redeployed, and a reduction in overall numbers of over 6,000;

· a range of measures are being actively progressed during 2012 to enhance income collection;

· a 7% increase in in-patient discharges and a 6% increase in ED admissions;

· in relation to a basket of 24 procedures, the national target of 75% of cases treated as day cases has been achieved;

· significant improvements in hospital waiting times, with 9,100 fewer patients waiting on trolleys when compared to the same period in 2011. This equates to a 19% year-on-year improvement;

· implementation of clinical programmes which saved 70,000 bed days last year, thereby allowing for more patients to be treated more efficiently;

· cost reductions within the health sector which are impressive by international standards, particularly within the hospital sector;

· 1.8m people now with medical cards, and 130,000 with GP visit cards;

· legislation to abolish restrictions on GPs wishing to become contractors under the GMS was passed and has come into effect;

· significant advances in mental health services in the implementation of A Vision for Change, in particular improved child and adolescent mental health services;

· advances in the care of older people, with almost 23,000 clients now supported under Fair Deal;

The Health (Pricing and Supply of Medical Goods) Bill 2012 was recently published and is being introduced in the Seanad today. The Bill provides for the introduction of a system of generic substitution and reference pricing. Currently, when a specific brand of medicine is prescribed for a patient, a pharmacist can only supply that particular brand, even when less expensive generic versions of the same medicine are available. The Bill permits pharmacists to substitute medicines which have been designated as interchangeable by the Irish Medicines Board.

Primary care facilities will be developed at twenty locations across the country using the public private partnership mechanism. This demonstrates the Government's commitment to the delivery of health care in the primary care setting. This PPP initiative will complement and build on the processes HSE has already in place in its capital programme. Primary care infrastructure development, through a combination of public and private investment, will facilitate the delivery of multidisciplinary primary health care and represents a tangible refocusing of the health service to deliver care in the most appropriate and lowest cost setting. The Exchequer will continue to fund the delivery of Primary Care Centres also.

On 17th July 2012, I announced the planned recruitment of over 270 new staff to work in Primary Care, funded by a special allocation of €20m which was set aside as part of the HSE's 2012 National Service Plan. The funding will provide for the employment of 17 Clinical Nurse Specialists to support the Integrated Care Diabetes Programme and some 255 other Primary Care Team posts, including Public Health Nurses, Registered General Nurses, Physiotherapists, Occupational Therapists and Speech and Language Therapists.

I can also report progress in chronic disease management, particularly for the management of diabetes and on the preparation of legislation to allow for the extension of free GP care to persons with long term illnesses.

In relation to the governance of the HSE, the Health Service Executive (Governance) Bill 2012 was published on 18th July. The legislation will allow the putting in place of a Director General and six new Directorates, closely aligned to specific areas of service such as primary care, mental health, hospitals and more. The new structure will allow a reorganisation of services to prepare the way for the wider introduction of the 'money follows the patient principle' and the ultimate introduction of Universal Health Insurance. The Health Service Executive (Governance) Bill 2012 will:

(i) abolish the Board structure of the Health Service Executive (HSE) and provide for a Directorate to be the new governing body for the HSE in place of the Board, headed by a Director General;

(ii) provide for further accountability arrangements for the HSE; and

(iii) provide for related matters including a number of technical amendments to take account of the replacement of the Board structure by the Directorate structure.

My priority over the next twelve months will be to accelerate the type of service delivery reforms that will move to models of care across all service/care groups which treat patients at the lowest level of complexity and provide services at the best possible unit cost. We will move further towards a health system that provides access based on need rather than income, underpinned by a strengthened primary care sector, a restructured hospital sector and a more transparent "money follows the patient" system of funding that will be supported ultimately by Universal Health Insurance.

I have referred the other matters raised by the Deputy to the HSE for direct reply.