Written Answers Nos. 233-235
233. Deputy Denis Naughten asked the Minister for Health if he will list the current publicly-funded maternity units or section 38 voluntary maternity units which do not have on-site mental health services provided by a consultant; and if he will make a statement on the matter. [21751/13]
View answerMy Department is in the process of obtaining the requested information and I will respond to the Deputy when this is available.
234. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will outline the process for drafting the White Paper on universal health insurance including membership of teams and the timeframe for same; and if he will make a statement on the matter. [21783/13]
View answerThe Government is embarking on a major reform programme for the health system, the aim of which is to deliver a single-tier health service, supported by universal health insurance (UHI), where access is based on need, not on income. Under UHI, everyone will be insured and will have equal access to a standard package of primary and acute hospital services, including acute mental health services. A new Insurance Fund will subsidise or pay insurance premiums for those who qualify for a subsidy.
The Department is currently preparing a White Paper on Universal Health Insurance which will provide further detail on the UHI model for Ireland in addition to the estimated costs and financing mechanisms associated with the introduction of universal health insurance. Broadly, this involves the development of detailed policy proposals covering issues such as the design of the UHI model, the scope and composition of the UHI basket of services and funding and financial support mechanisms for UHI. More detail in relation to the overall process for producing the White Paper, including the projects, studies and policy appraisals that need to be undertaken, is set out in the preliminary document on UHI, The Path to Universal Healthcare, published by the Department in February 2013 and available on its website, www.doh.gov.ie.
A special UHI Design Team has recently been set up to oversee and support the work involved in the design of the UHI model and the preparation of the White Paper on Universal Health Insurance. The membership of the UHI Design Team is as follows:
- Laura McGarrigle, Principal Officer, Universal Health Insurance Unit, Department of Health (Chair);
- Emer Brady, Assistant Principal Officer, Universal Health Insurance Unit, Department of Health;
- Aine Carroll, National Director for Clinical Strategy and Programmes, Health Service Executive;
- Matt Collins, Principal Officer, Eligibility Unit, Department of Health;
- Tom Heffernan, Principal Officer, Department of Public Expenditure and Reform;
- Jean Long, Head of Evidence Generation and Knowledge Brokering Unit, Health Research Board;
- Hugh Magee, Senior Statistician and Principal Officer, Information Unit, Department of Health;
- Mark Moran, Former CEO of the Mater Private Hospital and former Chairman of the DoH/ HSE Working Group on Reference Pricing and Generic Substitution;
- Deirdre Mulholland, Office of the Chief Medical Officer, Department of Health;
- Robert Murphy, Assistant Principal Officer, Universal Health Insurance Unit, Department of Health;
- Dermot Ryan, Principal Officer, Private Health Insurance Unit, Department of Health;
- David Smith, Principal Officer, Finance Unit, Department of Health, and
- Valerie Walshe, Economist, Health Service Executive.
The work involved in UHI design is both complex and technical and demands a wide-range of legal and financial expertise. Accordingly, it is envisaged that the Design Team will be supported by specialised expertise at appropriate junctures. To this end, the Department has recently engaged legal expertise to support deliberations in relation to the design of the UHI model.
Work on the development of detailed policy proposals is proceeding with a view to publishing the White Paper as early as possible.
235. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will detail the money follows the patient pilot project and plans to further extend this scheme; and if he will make a statement on the matter. [21784/13]
View answerThe draft Money Follows the Patient Policy Paper, which I published for consultation on 15 February last, proposes the introduction of a new model of funding for public hospital care. This involves changing from the current inefficient system of block grant budgets to a new approach where hospitals are paid for the actual level of activity they undertake. The new approach will be facilitated through the introduction of a prospective case-based payment system using Diagnosis Related Groups (DRG) and effectively means that hospitals will be funded on the basis of the quantity and quality of the services they deliver to patients and not the size of last year’s budget.
It is proposed that ‘Money Follows the Patient’ will begin in shadow form in 2013. Under shadow funding, hospitals will continue to receive their existing base budget under a vote cashing system. However, a process will be put in place to compare on a systematic basis, (i) actual hospital activity against pre-agreed baseline activity targets and (ii) hospital expenditure against pre-agreed DRG prices. In this way funding variances and potential impacts will be highlighted although no changes would be made to a hospital’s budget on foot of the exercise. It is my intention to announce the composition of the Hospital Groups shortly, subject to Government approval, and it is proposed that shadow funding will be rolled out to the Hub hospital of each Group. This approach allows Hospital Groups time to develop while still facilitating shared learning across the entire Group. It also enables the health system to leverage maximum efficiencies and economies of scale when investing in necessary resources, thereby reinforcing the optimally efficient service delivery model envisaged in the creation of Hospital Groups.
It is proposed that the system will then move from shadow funding to full phased implementation of ‘Money Follows the Patient’ from 1 January 2014, subject to fully developed hospital groups and central financial management systems being in place.
