Dáil Éireann Debate, Tuesday - 24 April 2012
706 Deputy Billy Kelleher asked the Minister for Health if a plan is in place to ensure that general practitioners are adequately trained to deal with chronic illness patients; and if he will make a statement on the matter. [19951/12]
Amharc ar fhreagra707 Deputy Billy Kelleher asked the Minister for Health if additional funding will be made available to fund the treatment of chronic illness patients in primary care settings; the source of this funding; and if he will make a statement on the matter. [19952/12]
Amharc ar fhreagra708 Deputy Billy Kelleher asked the Minister for Health the length of the trial period of the demonstrator models for treating chronically ill patients in primary care centres; the names and locations of these centres; when he expects the structure to be rolled out nationally; and if he will make a statement on the matter. [19953/12]
Amharc ar fhreagra709 Deputy Billy Kelleher asked the Minister for Health his views on whether primary care teams have had sufficient investment to ensure that they are ready to deal with chronic illnesses; and if he will make a statement on the matter. [19954/12]
Amharc ar fhreagra710 Deputy Billy Kelleher asked the Minister for Health when a new programme for diabetes care will be finalised; the new resources that will be made available for this programme; and if he will make a statement on the matter. [19955/12]
Amharc ar fhreagra721 Deputy Jonathan O’Brien asked the Minister for Health his plans to transfer resources from hospitals to allow general practitioners a greater role in treating patients with serious illnesses; the locations of the 20 primary care centres to be chosen to act as demonstrator models for a new approach to the treatment of chronically ill patients in the community. [20118/12]
Amharc ar fhreagra722 Deputy Jonathan O’Brien asked the Minister for Health the level of resources that will be transferred from hospitals to primary care and the timeframe in which this will happen. [20119/12]
Amharc ar fhreagraI propose to take Questions Nos. 706 to 710, inclusive, 721 and 722 together.
The HSE is developing chronic disease programmes to improve patient access and to manage patient care in an integrated manner across service settings. The programmes aim to deliver better health outcomes, enhanced clinical decision making and more effective use of resources. Work is ongoing on the development of the following programmes which are particularly relevant to primary care: Diabetes; Stroke; Heart Failure; Asthma; and COPD.
The Diabetes programme is due to commence in Quarter 4 of 2012. The model of care for the Integrated Care Diabetes Package prescribes that:
1. Uncomplicated Type 2 Diabetes patients will be managed in Primary Care only.
2. Patients with complicated Type 2 Diabetes, as defined by the National Model of Diabetes Care, will be managed by both primary and secondary care.
3. All patients with Type 1 Diabetes, genetic causes of Diabetes (MODY Diabetes), secondary causes of Diabetes, post-transplant Diabetes and pregnancy and Diabetes, will be managed in secondary care only.
A National Steering Committee has been set up to oversee implementation of the Diabetes programme and the key work streams are:
Alignment of 10 pilot diabetes initiatives with nationally agreed model of care;
Selection of Phase 1 sites;
Recruitment of Integrated Care Diabetes Nurse Specialists;
Progression of ICT Development;
Discussions with Irish Medical Organisation (IMO) and other relevant parties;
Identification of Drug Savings.
The work stream to identify Phase I sites is now complete. Primary Care Teams within the 4 HSE areas have been identified and GP practices have been mapped to these Teams. The results will be presented to me shortly for consideration. I would envisage that an announcement will be made thereafter.
The rollout of the national Diabetes programme is to be phased over 4 years (2012-2015) as follows—
In 2012, it is aimed to cover up to 1 million of the population;
2013 targeted to cover additional population of 1.7 million;
2014 targeted to cover further additional population of 1.7 million;
2015 targeted to cover final population of 0.45 million.
€2 million is required for the Diabetes programme in 2012 and this has been identified from within existing HSE resources. Funding for implementation in 2013 to 2015 is dependent on the identification of savings within the health system which will be re-invested in diabetes care.
In relation to investment in Primary Care Teams, funding of €20 million has been provided in the HSE's 2012 National Service Plan to fill as many vacancies as possible in primary care that have arisen as a result of the recent public service retirements and to expand existing arrangements where sessional services are provided by allied health professionals. At this time of scarce national resources, it is essential that such posts will be allocated according to an objective assessment of needs. The HSE is accordingly analysing the current provision of posts in proportion to population and population health needs to identify which areas are least well served.
The allocation of the extra posts will be subject to approval by the Universal Primary Care Project Team, which has been tasked with working through the issues relating to the Programme for Government commitments on Primary Care.
GPs and Primary Care Teams will also be supported in the provision of chronic disease management by a number of complementary initiatives including the development of clinical care pathways and electronic patient information systems.
The Programme for Government provides for the introduction of a new GMS contract with GPs with an increased emphasis on the management of chronic conditions, such as diabetes and cardiovascular conditions. It is envisaged that the new contract, when finalised, will focus on prevention and will include a requirement for GPs to provide care as part of integrated multidisciplinary Primary Care Teams. GPs already undergo 4 years vocational training, which includes training in chronic disease management.
