Dáil Éireann debate -
Tuesday, 11 Feb 2003

Vol. 561 No. 1

Written Answers. - National Health Strategy.

Caoimhghín Ó Caoláin

Question:

441 Caoimhghín Ó Caoláin asked the Minister for Health and Children if he will report on the progress regarding the implementation of the national health strategy since Dáil Éireann rose for the Christmas recess; and the progress made on Action 89, which promises greater equity for public patients in a revised contract for hospital consultants. [3514/03]

Minister for Health and Children (Mr. Martin):

In 2001, I launched the national health strategy, a comprehensive strategic plan for the health system. The strategy is a seven to ten year plan and several key actions will take the full ten years to implement – for example, the primary care strategy. A detailed progress report on developments in 2002 was given at the reconvened national consultative forum held on 11 November last and a report on progress has also been made available to the Cabinet committee on the health strategy. An additional €694 million has been allocated to the health service for 2003, bringing the total health spend for this year to €8.9 billion, including capital.

In relation to the health strategy, this provision will enable further advancement in a range of specific areas. Action 78 relates to the provision of additional acute hospital beds for public patients. An extra €53 million in 2003 has been provided for the completion of the programme of 709 additional beds in acute hospitals. The overall investment in bed capacity over 2002 and 2003 is therefore €118 million, including capital. Action 55 relates to a programme of investment to provide the necessary capacity in primary care, acute hospitals and other services. Additional funding of €514 million has been made available to improve health infrastructure further and allow for progress on projects. Action 81 relates to the reduction of waiting times for public patients. A total of €31 million has been made available in 2003 for the treatment purchase fund in addition to substantial base funding of €43 million for the waiting list initiative.

Action 61 relates to the further development of organ transplant services. This year, an additional €4.5 million has been made available for the lung transplant programme at the Mater Hospital, Dublin. Actions 76 and 77 relate to the develop ment of primary care. An additional €10 million has been provided for the development of primary care including GP co-ops and primary care units in 2003. In relation to homelessness – Action 21 – a total of €4.2 million in additional funding has been provided, consisting of €2.7 million targeted at adult homelessness and €1.5 million targeted at youth homelessness. A further €6 million has been provided for the development of childcare services, including family support services, under Action 27. An additional €7.6 million will be invested in mental health services this year under Action 25. An additional €28.4 million has been provided for 2003 to improve services for people with disabilities and to develop further the availability of appropriate care in an appropriate setting under Actions 54 and 55.

An additional sum of €29 million has been allocated for cancer services this year. This investment will enable us to continue to address increasing demands in cancer services in such areas as oncology and haematology services, oncology drug treatments and symptomatic breast disease services under Action 12. Additional funding of €7 million has been provided for the further implementation of the cardiovascular strategy under Action 5. Further funding of €12.6 million has been made available in 2003 for services for older people under Actions 26 and 55. Additional funding of €2.4 million has been provided for palliative care under Action 31.

My Department is currently engaged in discussions with the health boards on their service plans for 2003 which detail,inter alia, their plans for the continued implementation of the strategy this year. In relation to Action 89 of the health strategy, it is hoped that the negotiation of a new consultants' contract will commence soon. Much of the foundation for these talks has been put in place, with my Department successfully negotiating the introduction of a revised grievance and disputes procedure with the consultants' representative bodies. In addition, discussions regarding a revised administrative leave scheme for consultants have been productive, although this has yet to be finalised.

It is my Department's intention that the talks on a new contract will take cognisance of the recommendations made in the report of the Forum on Medical Manpower, the Hanley report on NCHD working hours, the forthcoming report of the task force on medical staffing and other recent reports. The implementation of these recommendations will lead to increased productivity, greater flexibility in work practices, enhanced team working and improved accountability of consultants in their provision of public health services. Particular emphasis will obviously be placed on the intention, outlined in the health strategy, to provide a more equitable system of health care for public patients. This will necessitate improved access for public patients, the restructuring of services to provide greater focus on the public patient and the improvement in the development of services for public patients. There is no doubt that implementation of the strategy involves challenges for everyone in the health system. Its implementation must be underpinned by strong management of our economy. That is our best guarantee that the health strategy will be delivered.