Written Answers. - Health Strategy.
Ivor Callely
Question:
56
Mr. Callely
asked the
Minister for Health and Children
the time scale for the new health strategy to have a beneficial impact on the provision of the health services; and if he will make a statement on the matter.
[30755/01]
Over the last four years there has been substantial investment in and development of health services in Ireland. The aim of the strategy document is to move away from short-term approaches to planning and to provide a blueprint for the whole health system to realise ambitious and wide-ranging change over the next seven to ten years.
The Government's commitment to health as a key priority area is underlined by the comprehensive targets set in the strategy. It is a long-term programme but it sets out a very clear plan and a very clear vision for the future. In setting out such a comprehensive and large-scale plan, it is inevitable that prioritising of actions must take place. This is, after all, a seven to ten year programme. The strategy represents a clear plan for moving forward which is based on a step by step approach to reducing inequalities in the system and building the necessary capacity to meet the growing needs of the population.
Our first priorities are the reduction of waiting lists, strengthening primary care, improvements in services for people with disabilities and for older people and also to ensure that those who have eligibility, can actually gain access to the services they are entitled to. This means building up capacity in core services.
This is why the Government has prioritised the creation of 3,000 extra hospital beds, all of which will be designated for public patients. Some 650 of these will be in place by the end of 2002. The putting in place of the treatment purchase fund is another element in this strategy to protect equity for public patients. A treatment purchase team will be appointed very quickly. This team will arrange for the purchase of treatments for public patients who have waited for more than three months from their out-patient appointment. The team will set targets and monitor progress over the next three years. In the first instance, the focus will be on patients who have waited longest, consistent with clinical need.
This initiative represents a concentrated, focused drive to reduce waiting times for public patients, so that we ensure no patient has to await treatment for unacceptably long periods of time. The target is to have reduced waiting times by the end of 2002 to 12 months for adults and six months for children; by the end of 2003 to six months and three months respectively and by 2004 to have reduced waiting times to three months for all public patients.
Beginning the work on the vision of primary care for the future is also vitally important. This is a radical long-term programme which needs to build up momentum as quickly as possible in order to achieve the targets we have set ourselves by the end of 2011. This model seeks to address this problem putting in place co-ordinated integrated one stop shops for service that will be of particular benefit to older people and medical card holders. The first step will be the expansion of 24-hour, seven-day GP co-operatives beginning straight away. This will be supported by the immediate establishment of a primary care task force to help drive the roll-out of a new model. The emphasis will be on putting together primary care teams which can meet the needs of patients and clients effectively. Patients will have the option of enrolling with these teams, and with an individual general practitioner. If they so wish, they will be able to self-refer to any member of the team. The plan is to have an out-of-hours service and GP co-operative arrangements extended nationally by the end of 2003, with the first 20 to 30 primary care implementation teams in place by the same date.
Continuing care services for people with disabilities and older people are also being prioritised. People with disabilities will gain from the addition of a significant number of extra day places, respite care places and residential capacity being put in place from the beginning of next year.
Older people will also benefit substantially. Our commitment here is for a total of 1,370 extra assessment and rehabilitation places, 600 extra day places and for 800 extra residential or community nursing places per annum each year over the next seven years. The first of these additional places will be put in place next year. These improvements will bring real, tangible benefits for older people.
The Deputy should note that health services are only one factor in determining the health of a nation. The Government's focus has been to look beyond health services to tackle health status by strengthening inter-sectoral responses to health needs and by placing health at the centre of public policy both inside and outside of the health system. A number of actions related to the issue of population health status will also be completed next year. These include actions which are aimed at improving people's living and working environments, reducing the incidence of smoking, programmes focused on children's early health and social development, as well as a range of provisions to plan for and promote better health status and quality of life for the most vulnerable groups in our society.
A number of actions will also make services more accessible through: clearer rules regarding eligibility; designation of new beds for public patients only; improvements in way accident and emergency and out-patient departments are organised; and much improved communication especially for hard to reach groups.
These actions are also front-loaded for next year. Other basic provisions such as specific appointment times and improvements in opening times can also commence quickly.
A very important aspect of improving services will be listening to what people tell us about services they use. An agreed system of patient feedback will be published and implemented by the end of 2002. In addition, during 2002, a range of community level structures to give communities a voice in the planning of services will be established.
What I have outlined to you here are some of the key elements of a strategy which is concerned with getting at the root of problems in the health system. This is not a plan for "quick wins" but a strategy which, if properly implemented on an incremental basis, has real potential to achieve our vision for the future. It has short, medium and long-term goals. Of the short-term priorities, I anticipate tangible improvements next year in the provision of acute hospital services in particular.
This strategy is unique in that it sets out a detailed plan with deliverables and target dates for implementation of the 121 actions listed. In addition, there are clear structures for overseeing the implementation process. I will be establishing a national steering group with external expertise in change management to guide implementation before Christmas. Arrangements are also under way to set up a dedicated national implementation team in my Department and I will be meeting the health board chief executive officers later this month to discuss implementation at regional and local level. I am confident that we can make progress quickly on many aspects of the strategy. In addition, we need to begin planning for the longer term objectives so that the essential groundwork to achieve change can be advanced.
