Written Answers. - Health Board Services.
Batt O'Keeffe
Question:
232
Mr. B. O'Keeffe
asked the
Minister for Health and Children
the proposals, if any, he has to deal with cost effectiveness within the Southern Health Board in view of the recent economic statement outlining the dramatic increase in funding with little return in cost effectiveness.
[20496/99]
I presume the Deputy is referring to the paper delivered by Dr. Sean Barrett of the Department of Economics, Trinity College, at the Irish Hospital Consultants Association conference in Tullamore on 2 October. Many of the assertions concerning the health services made in this paper are open to challenge. In this context it must be realised that demographic trends and developments in medical technology lead to much higher cost pressures in the health area over and above that experienced in the general economy.
The OECD, which Dr. Barrett refers to in his paper, in its review of the Irish care system in 1997 said that the system "had resulted in good provision of health care at relatively low cost to the taxpayer". The latest OECD report, 1999, states that the Irish health care system is continuing to work well.
In support of this case, I wish to refer to a whole range of initiatives which have been taken recently in pursuit of cost effectiveness.
The Deputy is aware that under the Health (Amendment) (No. 3) Act, 1996, health boards are required to submit an annual service plan to my Department setting out the level of service they will deliver for the financial determination they have received. The service planning discipline and structures now in place in health agencies such as the Southern Health Board and the continuing developments in this area will lead to enhanced cost effectiveness throughout the system.
A Healthcare Materials Management Board has been set up to guide best practice in the materials management area across the whole of the health sector to ensure that value for money is being achieved in each agency and through the combined purchasing power of all the health agencies.
There is an ongoing development of information communications technology aimed at enhancing the delivery and cost effectiveness through integrated care processes. These developments are contributing to the efficiency of service provision and the provision of better management information to assist in the pursuit of further cost effectiveness. The Southern Health Board has invested heavily in implementing modern information systems and is continuing to receive support from my Department to further support the delivery of health care services.
In the area of acute hospital services my Department has operated a system of costed casemix budgeting which ensures that cost effectiveness considerations are taken into account in determining hospital budgets. On the basis of casemix criteria, the Southern Health Board performs well and Cork University Hospital in particular has consistently been shown to operate in a cost effective manner.
The continued increases in activity demonstrate the system's ability to respond to the increasing demands placed upon it effectively. With regard to in-patient and day case activity, the total discharges nationally, both in-patient and day case, in the acute hospital system for the period January to December 1998 were 809,099. This huge volume of overall activity represented an increase of 3 per cent over 1997 levels. In particular, the level of hospital care being provided on a day case basis showed a very significant increase, up over 8 per cent in 1998 over 1997 levels. These activity trends are generally reflected by the Southern Health Board.
This upward trend in overall activity is continuing in the first six months of 1999 and the increases in the delivery of services, including the increased proportion of day cases, clearly indicate the increasing cost effectiveness in the delivery of health care services.
