Dáil Éireann Debate, Thursday - 20 April 2023
394. Deputy Bernard J. Durkan asked the Minister for Health if he is satisfied that the health services can be co-ordinated in such a way as to ensure a modern response to patients' needs in all areas throughout the country; and if he will make a statement on the matter. [18856/23]
View answerI can assure the Deputy that work is ongoing to integrate and co-ordinate our health and social care services, and to ensure that patients have rapid access to high-quality care in response to their needs throughout the country. With annual funding of €195 million allocated to the continued implementation of the Enhanced Community Care (ECC) Programme, for example, the process of integrating health care responses between acute and community settings - and of re-orienting the focus of service delivery towards primary and community care - is progressing. This means delivering more care closer to where patients live, in line with the objectives of Sláintecare. To date:
94 of the planned 96 Community Healthcare Networks (CHNs) are now established;
21 of 30 Community Specialist Teams (CSTs) for Older Persons are now established;
21 of 30 Community Specialist Teams for Chronic Disease Management are now established; and
21 Community Intervention Teams (CITs) are operational with national coverage secured, and these continue to be expanded.
The Community Healthcare Networks - for the first time in Ireland - provide for the integration of General Practice (GP) with wider community services. This provides the foundational structure for the delivery of integrated care, allowing for more local decision-making, and improving access to the primary care services that individuals, families, and carers need.
Alongside these, the Community Specialist Teams provide consultant-led multidisciplinary care to older persons, and those with chronic disease, in the community. This reflects the shift in focus away from the acute hospital and towards a primary and community-based service model in response to patient needs.
The Community Intervention Team service provides a rapid and integrated response to patients experiencing an acute episode of illness, and facilitates the delivery of enhanced care in the community or home setting. This prevents unnecessary hospital admission or attendance, and facilitates the discharge of patients to community care when clinically appropriate. We are currently providing for further expansion of CITs across the country, with a particular focus on the Mid-West and North-West regions.
Recruitment to the ECC Programme is continuing, with 2,356 WTEs having commenced their roles to date, while a further 244 WTE are at an advanced stage of recruitment, out of a total targeted recruitment of 3,500 staff.
Work also continues in the delivery of the GP direct referral pathway to diagnostics, so that patients can access these tests quickly and without seeing a consultant, and without having to attend hospital. This structured pathway for GPs to directly access diagnostic tests enables a greater level of care to be delivered in the community, supporting patient-centred care, early diagnosis, and early intervention.
Last year, over 250,000 diagnostic radiology scans including X-rays, CT scans, MRI scans and DEXA were provided nationally to patients referred directly by their GPs to contracted private providers, located in convenient settings within the community and closer to home.
We have ensured - through a funding allocation of €47 million to the initiative in Budget 2023 - that the full adult population is eligible to be referred for these outsourced radiology scans is maintained, and we are targeting delivery of over 240,000 radiology scans this year, with almost 90,000 scans already provided this year to date. Further to this, the initiative continues to be expanded to include provision of direct referral by GPs of their patients to Echocardiography, Spirometry and NT-proBNP blood tests in public laboratories and will target delivery of over 266,000 of these diagnostic tests this year.
In support of these ongoing reforms, the Government is also committed to the implementation of Regional Health Areas (RHAs), as outlined in the Programme for Government. RHA implementation involves the creation of six regional divisions in the HSE with responsibility for the planning and delivery of hospital, community and social care services within their respective areas. These new arrangements will improve the health service’s ability to deliver more joined-up care, integrated for patients that is planned and funded in line with regional and local needs.
While RHAs are not a panacea for all the challenges our system experiences, they are a necessary step towards providing rapid access to better, high-quality care for patients. RHAs will serve as an enabling platform for co-ordinating our acute, community, and primary care services and help to support a modern, equitable, and integrated response to patients' needs in all areas throughout the country.
