Dáil Éireann Debate, Tuesday - 1 February 2022
653. Deputy David Cullinane asked the Minister for Health the work which has been conducted in relation to general practice and primary care policy for implementation of Sláintecare; and if he will make a statement on the matter. [4361/22]
View answerThe Oireachtas Committee on the Future of Healthcare set out in the Sláintecare Oireachtas Report their vision to deliver safe, quality health and social care services that meets the needs of the growing population. The vision of Sláintecare is to achieve a universal single-tier health and social care system, where everyone has equitable access to services based on need, and not ability to pay.
General practice policies central to the implementation of Sláintecare are the reform of the GMS GP contract and the roll out of a Chronic Disease Management (CDM) programme for GMS patients, and the move towards universal access to GP services without charges on a phased basis. The key primary care policy supporting the implementation of Sláintecare is the development of the Enhanced Community Care programme.
The 2019 GP Agreement helps to modernise and reform the GMS scheme, expanding services for patients and making general practice a more attractive career option for doctors. As part of the agreement, the CDM programme for type 2 diabetes, asthma, COPD, and cardiovascular disease, commenced in 2020 and will be fully rolled out by 2023. The CDM programme aims to bring the care for chronic disease further into the community and reduce hospital attendance by patients with the four conditions.
Furthermore, the Agreement includes a commitment to undertake a strategic review of GP services within the lifetime of the Agreement, to examine how best to ensure the provision of GP services in Ireland for the future. The outcome of this review will inform future contractual changes, with preparatory work for the review having begun this year.
A number of measures have been introduced in recent years to expand access to GP care without charges. For example, since 2015, all children under the age of 6 years and all persons aged 70 and over are now automatically eligible for a GP visit card and since 2018, all those in receipt of either a full or half-rate Carer's Allowance or Carer's Benefit are automatically eligible for a GP visit card. In addition, Budget 2022 provides for the initial stage of the planned expansion of GP care without fees to all children aged 12 years and under, the provision of GP care without fees to all children aged 6 and 7, and work has commenced to roll this service out in the course of 2022.
The Enhanced Community Care (ECC) programme involves the development of new models of care and service delivery, maximising effectiveness and with integration as a core value as identified by Sláintecare.
Service delivery will be re-orientated towards General Practice, primary care and community-based services with CHNs and Community Specialist Teams working in an integrated way with the National Ambulance Service and acute services to deliver end-to-end care, keeping people out of hospital and embracing a ‘home first’ approach. The utilisation of eHealth forms a central part of the ECC programme and is key to supporting integration of services.
The ECC’s various components can be summarised as encompassing six areas of action:
- Establishing CHNs to provide the foundation and organisational structure through which an integrated care system is provided locally based on population need and size.
- Implementing integrated care programmes for older people and chronic disease management;
- Expanding workforce and infrastructure capacity in the community through targeted application of resources to a defined population. The focus will be on implementing best practice models of care to demonstrate the delivery of specific outcomes and sustainable services, which can be scaled for full national implementation;
- Expanding the range of services available in the community;
- Developing working arrangements for staff and contracted professionals to enable the delivery of expanded services;
- Developing an enabling environment for joined-up community working including ICT, data, clinical governance, patient safety and quality operating frameworks and systems.
These policy aims clearly align with the principles set out in the Sláintecare report, as well as with best practice principles enunciated internationally by WHO among others.
