Written answers
Tuesday, 9 October 2012
Department of Health
Programme for Government
Simon Harris (Wicklow, Fine Gael)
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To ask the Minister for Health if he will outline in tabular form the commitments in the Programme for Government pertaining to his ministerial portfolio; the current status of these commitments in terms of implementation; and if he will make a statement on the matter. [42881/12]
James Reilly (Dublin North, Fine Gael)
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As the Deputy may be aware the first Annual Report of the Programme for Government was published last March. It is the Government's intention to publish the second annual report in March 2013. The table that follows this reply sets out the current position in regard to health-related commitments. If further information is required, the Deputy can write to my Department.
| Introduce Universal Health Insurance with equal access to care for all. Under this system there will be no discrimination between patients on the grounds of income or insurance status. The two-tier system of unequal access to hospital care will end. The Universal Health Insurance system will be designed according to the European principle of social solidarity: access will be according to need and payment will be according to ability to pay. The principle of social solidarity will underpin all relevant legislation. As a statutory system of health insurance, guaranteed by the State, the Universal Health Insurance system will not be subject to European or national competition law. | In progress |
|---|---|
| Act speedily to reduce costs in the delivery of both public and private health care and in the administration of the health care system. | In progress |
| Introduce a system of risk equalisation for the current insurance market. | In progress |
| A Special Delivery Unit will be established in the Department of Health to assist the Minister in reducing waiting lists and introducing a major upgrade in the IT capabilities of the health system. | In progress |
| A Patient Safety Authority, incorporating HIQA, will be established. | In progress |
| The Minister for Health will be responsible for health policy and for implementing this ambitious programme of reform and cost control. | In progress |
| The Health Service Executive will cease to exist over time. Its functions will return to the Minister for Health and the Department of Health and Children; or be taken over by the Universal Health Insurance system. Staff will be deployed accordingly. | In progress |
| Health capital spending will be a priority. | In progress |
| Within the Health capital budget, the immediate priority areas will be primary care centres, step-down and long-term care facilities, and community care facilities such as day centres for older people. | In progress |
| The completion and commissioning of the cystic fibrosis unit will be expedited. | Completed |
| The National Children’s Hospital will be built. | In progress |
| Our policy on mental health incorporates the recommendations of A Vision for Change. We are committed to reducing the stigma of mental illness, ensuring early and appropriate intervention and vastly improving access to modern mental health services in the community. | In progress |
| We will endeavour to end the practice of placing children and adolescents in adult psychiatric wards. | In progress |
| We will review the Mental Health Act 2001 in consultation with service users, carers and other stakeholders, informed by human rights standards, and introduce a Mental Capacity Bill that is in line with the UN Convention on the Rights of Persons with Disabilities. | In progress |
| A comprehensive range of mental health services will be included as part of the standard insurance package offered under Universal Health Insurance. | In progress |
| Given the central role of primary care in our reforms, we will ensure that patients can access mental health services such as psychologists and counsellors in the primary care setting. | In progress |
| We will also strengthen GP education and training in mental health so that they can better diagnose, treat and refer as necessary. | In progress |
| We will ring fence €35m annually from within the health budget to develop community mental health teams and services as outlined in A Vision for Change to ensure early access to more appropriate services for adults and children and improved integration with primary care services. | In progress |
| Part of the ring-fenced funding will be used to implement Reach Out, the National Suicide Prevention Strategy, to reduce the high levels of suicide. | In progress |
| We will close unsuitable psychiatric institutions moving patients to more appropriate community-based facilities. | In progress |
| We will develop specific strategies for elderly patients and those with intellectual disabilities who remain under the care of mental health services. | In progress |
| To ensure a joined-up approach to mental health in the community we will establish a cross-departmental group to ensure that good mental health is a policy goal across a range of people’s life experiences including education, employment and housing for example. | In progress |
| We will develop a national Alzheimer’s and other dementias strategy by 2013 to increase awareness, ensure early diagnosis and intervention, and development of enhanced community based services to be implemented over five years. | In progress |
| We will introduce a cervical cancer vaccination catch-up programme for all girls in secondary school. | Completed |
| We will also extend Breastcheck to 65-69 year old women. | In progress |
| We will develop a National Carers Strategy to support carers and to address issues of concern. | Completed |
| We will reopen discussions with the Irish Thalidomide Association regarding further compensation for victims of Thalidomide. | In progress |
| We will seek a mechanism to compensate those women who were excluded on age grounds alone from the Lourdes Hospital Redress Scheme. | In progress |
| We will legislate to clarify the law surrounding assisted human reproduction including the law relating parental relationships arising from assisted human reproduction. | In progress |
| We will legislate to regulate stem cell research. | In progress |
| We acknowledge the recent ruling of the European Court of Human Rights subsequent to the established ruling of the Irish Supreme Court on the X-case. We will establish an expert group to address the recent ruling of the European Court of Human Rights subsequent to the established ruling of the Irish Supreme Court on the X-case, drawing on appropriate medical and legal expertise with a view to making recommendations to Government on how this matter should be properly addressed. | In progress |
| We will legislate for post-mortem procedures and organ retention practices as recommended by the Madden report. | In progress |
| We will legislate to change the organ donation to an opt-out system for organ transplantation, rather than an opt-in system so as to improve the availability of organs for patients in desperate need. | In progress |
| Universal Primary Care will remove fees for GP care and will be introduced within this Government’s term of office. | In progress |
| Access to care without fees will be extended to all in the final phase. | In progress |
| GPs will be paid primarily by capitation for the care of their patients and will work in primary care teams with other primary care professionals. | In progress |
| A new GP contract will provide incentives to GPs to care more intensively for patients with chronic illnesses. This will significantly reduce pressures and demands on the hospital system. | In progress |
| Registration with a primary care team will be compulsory once the Universal Primary Care system is fully implemented. | In progress |
| Exchequer funding for primary care will go to a Primary Care Fund on a transitional basis, which will pay providers of primary care. | In progress |
| The goal under UHI will be to create an integrated system of primary and hospital care. | In progress |
| Ring-fenced funding will be provided to recruit additional psychologists and counsellors to community mental health teams, working closely with primary care teams to ensure early intervention, reduce the stigma associated with mental illness and detect and treat people who are at risk of suicide. | In progress |
| The legislative basis for Universal Primary Care will be established under a Universal Primary Care Act. | In progress |
| Universal Primary Care will be introduced in phases so that additional doctors, nurses and other primary care professionals can be recruited. | In progress |
| GP training places will be increased. | In progress |
| GPs will be encouraged to defer retirement and will be recruited from abroad | In progress |
| The number of practice nurses will be increased so that GPs can delegate care when appropriate to nurses. | In progress |
| Access to primary care without fees will be extended in the first year to claimants of free drugs under the Long-Term Illness scheme at a cost of €17 million. | In progress |
| Access to primary care without fees will be extended in the second year to claimants of free drugs under the High-Tech Drugs scheme at a cost of €15 million. | In progress |
| Access to subsidised care will be extended to all in the next phase. | In progress |
| A system of Universal Health Insurance (UHI) will be introduced by 2016, with the legislative and organisational groundwork for the system complete within this Government’s term of office. | In progress |
| Under UHI insurers will be obliged to offer the same package of services to all. | In progress |
| This guaranteed UHI package will be determined by the Minister for Health in consultation with the Hospital Insurance Fund and medical experts and will be regularly reviewed in a process to be established in legislation, the Universal Health Insurance Act. | In progress |
| Insurers will not be allowed to sell insurance giving faster access to procedures covered by the UHI package. | In progress |
| Hospitals and clinics which participate in supplying care under UHI will not be allowed to sell faster access to procedures covered by the UHI package. | In progress |
| A White Paper on Financing UHI will be published early in the Government’s first term and will review cost-effective pricing and funding mechanisms for care and care to be covered under UHI. | In progress |
| The legislative basis for UHI will be established by the Universal Health Insurance Act. | In progress |
| UHI will provide guaranteed access to care for all in public and private hospitals on the same basis as the privately-insured have now. | In progress |
| Insurance with a public or private insurer will be compulsory with insurance payments related to ability to pay. | In progress |
| The State will pay insurance premia for people on low incomes and subsidise premia for people on middle incomes. | In progress |
| Everyone will have a choice between competing insurers. | In progress |
| The VHI will be kept in public ownership to retain a public option in the UHI system. | In progress |
| Exchequer funding for hospital care will go into a Hospital Insurance Fund which will subsidise or pay insurance premia for those who qualify for subsidy. | In progress |
| The Hospital Insurance Fund will oversee a strong and reformed system of community rating and risk equalisation; provide direct payments to hospitals for services that are not covered by insurance such as Emergency Departments and ambulances; and provide matching payment to hospitals for treatments delivered. | In progress |
| The Hospital Insurance Fund will also control those health care costs for which central control is most effective. | In progress |
| Enact legislation to prohibit the practice of Female Genital Mutilation for the protection of girls and women. | Completed |
| Outline key priorities for short-term implementation of the National Addiction Strategy, underpinned by a realistic timeframe and targets. | In progress |
| Require all local and regional drugs taskforces to build on the success of Education Prevention Units in other taskforces. | In progress |
| Target resources to increasing the number of needle exchange programmes and rehabilitation places across the country where it is needed most. | In progress |
| Assist drug users in rehabilitation through participation in suitable local community employment schemes. | In progress |
| Expand rehabilitation services at local level in line with need and subject to available resources. | In progress |
| Integrate drug and alcohol abuse strategies at local level | In progress |
| Develop compulsory as well as voluntary rehabilitation programmes. | In progress |
| Ensure every Government Department, Agency or task force responsible for implementing elements of the National Addiction Strategy will be required to account to the Minister for their budget annually and to demonstrate progress on achieving targets. | In progress |
| Work with Local and Regional Drug Task Forces to implement effective programmes aimed at preventing addiction in schools. | In progress |
| Under UHI public hospitals will no longer be managed by the HSE. They will be independent, not-for-profit trusts with managers accountable to their boards. Boards will include representatives of local communities and staff. | In progress |
| The existing policy of co-location of private hospitals on public hospital lands will cease. | Completed |
| Smaller hospitals may combine in a local hospital network with a shared management and board. | In progress |
| Hospitals will be paid according to the care they deliver and will be incentivised to deliver more care in a “money follows the patient” system. | In progress |
| Insurers will negotiate directly with hospitals to help control costs and encourage innovation in the delivery of care. | In progress |
| Insurers will not take over the running of hospitals which will be independent providers of care separate from insurers as purchasers of care. | In progress |
| The Minister for Health will be responsible for hospitals policy and determining that hospitals which play an important role in an area should not be allowed to close under UHI. | In progress |
| The Hospital Insurance Fund will assist hospitals in more remote locations that may not have a large throughput of patients to continue to provide important local services. | In progress |
| To ensure that hospitals compete on an equal footing, public hospitals will be compensated for costs that they bear that private hospitals do not such as Emergency Departments and training health care professionals. | In progress |
| The Patient Safety Authority will introduce a national licensing system for hospitals, and will oversee the transition of hospitals from the HSE to independent local control. | In progress |
| Ensure that the quality of life of people with disabilities is enhanced and that resources allocated reach the people who need them. To achieve this, we will reform the delivery of public services to bring about back office savings that will protect front line services. | In progress |
| A Comprehensive Spending Review will examine all provision for people with disabilities with a view to determining how users can get the best services. We will also ensure that money spent on disability services under the National Disability Strategy is clearly laid out and audited. | In progress |
| Move a proportion of public spending to a personal budget model so that people with disabilities or their families have the flexibility to make choices that suit their needs best. Personal budgets also introduce greater transparency and efficiency in funding services. | In progress |
| Put the National Standards for Residential Services for People with Disabilities on a statutory footing and ensure that services are inspected by the Health Information and Quality Authority. | In progress |
| In the first term of this Government the legislative basis for UHI will be enacted. | In progress |
| In the first term of this Government public hospitals will be given autonomy from the HSE. | In progress |
| In the first term of this Government the HSE’s function of purchasing care for uninsured patients will be given to a Hospital Care Purchase Agency which will combine with the National Treatment Purchase Fund to purchase care for the uninsured over this transition period. This separation of purchaser-provider functions will enable the development of a money follows the patient system of purchase of care for people without insurance before the implementation of the UHI system. | In progress |
| Investment in the supply of more and better care for older people in the community and in residential settings will be a priority of this Government. | In progress |
| Additional funding will be provided each year for the care of older people to fund more residential places, more home care packages and the delivery of more home help and other professional community care services. | In progress |
| The Fair Deal system of financing nursing home care will be reviewed with a view to developing a secure and equitable system of financing for community and long-term care which supports older people to stay in their own homes. | In progress |
| The integration of care in all settings is key to efficient health care delivery, in which the right care is delivered in the right place. | In progress |
| Integration of care will be the responsibility of an Integrated Care Agency under the aegis of the Minister for Health. | In progress |
| This agency will oversee the flow of centrally tax-funded resources between the different arms of the system so that there are incentives for care to occur in the best setting. | In progress |
| Reference pricing and greater use of generics will be introduced to reduce the State’s large drugs bill and the cost to individuals of their medications. | In progress |
| Under the new GP contract the rate of remuneration of GPs will be reduced. | In progress |
| Under a new consultant’s contract hospital consultants’ remuneration will be reduced. | In progress |
| Action will be taken to reduce the cost of procurement for medical equipment and construction of facilities. | In progress |
| The Minister for Health and the Department of Health will be responsible for policy and spending. | In progress |
| The HSE will cease to exist as its functions are given to other bodies during this process of reform. | In progress |
| The HSE hospital purchasing arm will merge with the NTPF to become a new purchaser of public patient care during this period of transition. | In progress |
| HSE hospitals will become autonomous providers of care. | In progress |
| We will also develop and implement national standards for home support services which are subject to inspection by the Health Information and Quality Authority. | In progress |
| We will complete and implement the National Positive Ageing Strategy so that older people are recognised, supported and enabled to live independent full lives. | In progress |
| We will support older people in living in their own homes and communities for as long as they wish and will facilitate this by ensuring that the eligibility criteria for the home help and the Home Care Package Scheme are applied consistently. | In progress |
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