Vol. 569 No. 3
82 Ms O. Mitchell asked the Minister for Health and Children the way in which it is envisaged that the proposed new health structures will impact on the nature of and timetable for, delivery of the Government's health strategy. [17705/03]
The health reform programme has its origins in the health strategy. It provides a central platform for the six frameworks for change which were identified as key to advancing the goals and objectives of the health strategy. Those are: strengthening primary care; reform of the acute hospital system; funding; developing human resources; organisational reform; and information. Those reforms are essential to the advancement of the strategy as a whole. Without them, the health services would not be able to respond adequately to their strategic objectives.
For example, the reformed structures are built around the need to create a system within which the primary care model could develop and grow. Regarding hospital services, it clears the way for a reorientation of the hospital sector around national priorities, high quality, best outcomes and better value for money. Regarding the information deficit, it restates the need to establish an independent authority to support the development of information systems which are inextricably linked to the quality agenda in health. That strengthening of information systems will also provide a greater evidence base for proper monitoring and evaluation of system performance.
It deals with the repeated criticisms regarding accountability within the system, with greater clarity between roles, clearer lines of accountability and best-practice governance. Regarding efficiency and value for money, it also provides for the development of shared services, where economies of scale should lead to resources being freed for front-line services, improved standardisation and a pooling of expertise and best practice.
The delivery of some actions in the strategy will be linked to investment, something that will continue to be true. However, improving value for investment made and structuring the health system so it can more easily achieve its goals, is a vital step. It will ensure that the system can absorb additional investment effectively and help to demonstrate to the taxpayer and my colleagues in Government that any additional money invested will be well spent in delivering an improved service to patients and clients.
The new structures must have a positive impact on the delivery of the Government's health strategy. That is their central premise.
I accept the Minister's point that the delivery of the strategy requires new structures. I would not argue with that. However, many of the strategy's promises are already overdue. I believe it was the Secretary General of the Department who pointed out recently that, over the next 18 months, the priority focus of the Department and the health boards would be the setting up of the new structures. Given the current state of the health service and the crisis that exists, it seems that it should not be the entire focus of attention for the Department and the health boards. If all the concern, attention and resources, both financial and human, are merely directed to structural reform, the delivery of the strategy itself will fall further and further behind. Does the Minister share that concern? If I may ask a supplementary question, I would like to pursue the points made about the IT strategy.
First, about 70% of the 121 actions to which we committed ourselves in the health strategy are under way and have commenced. We have made significant progress on several fronts. On others we have not made as much progress. I regard structural reform as an essential prerequisite for the full realisation of the strategy over the next decade. After all, we said initially that we would start off with the health strategy. The key analysis then was to assess whether the existing structures were adequate to respond to the objective of the strategy itself. That exercise has now come to fruition in the form of the Prospectus report, and the Commission on Financial Management and Control Systems in the Health Service has come forward in the context of financial management and planning. One cannot separate structures from services. There is a link between the two. A significant effort will be made over the next 18 months to implement the structural reform programme as announced last week by the Government. In tandem with that, the normal Estimates campaigns will continue. The Department will continue to promote its agenda regarding financial allocations and need in line with our health strategy, and that must obviously be considered in the context of overall Government budgetary considerations.
The IT strategy is behind and on hold. In the context of the new structures, whereby hospitals and most of the health service will be delivered centrally from a Dublin office – I presume it is Dublin and not Cork – or from a central hospitals agency or executive, I would imagine that information is vital. Whatever local knowledge one might have in a health board about the needs of hospitals, populations and employees, it is difficult to have it in Dublin. What is happening about the IT strategy? I know that there will be funding, for I understand the sums of money involved are enormous. I am told that €200 million will not even suffice. That is the critical investment—
The Deputy should ask her question. We are short of time.
It is a matter of realising potential.
I agree with the Deputy that information is key and an essential component of the reform programme and the needs of the health service. We have suffered from historic underprovision regarding a comprehensive information database for health and the ICT dimension. There has been investment in ICT over recent years. As the Deputy is aware, the proposal in the reform programme is to set up the health information quality authority, known as the HIQA. The health information strategy was delayed pending publication of the reform programme. The idea is that we should have an independent body responsible for quality assurance and the gathering, compilation and publication of data pertaining to health and related matters. I expect that we will be able to publish the health information strategy or at least to bring it to Government within the next few weeks.
