Dáil Éireann Debate, Thursday - 16 April 2015
35. Deputy Caoimhghín Ó Caoláin asked the Minister for Health his plans for increased chronic care management in general practice; the form this will take; the increased funding that will be provided for this; when new contracts with general practitioners will be negotiated; and if he will make a statement on the matter. [14713/15]
Amharc ar fhreagraFollowing intensive engagement, the Department of Health, the HSE and the Irish Medical Organisation have reached agreement on a package of measures, including terms for the delivery of free GP care for all children aged under 6 years; the provision of GP care without fees to all persons aged 70 years and over under the existing GMS contract; and the introduction of a Diabetes Cycle of Care for medical card or GP visit card holders who have Type 2 Diabetes. The aim is to commence the GP service for under 6s and over 70s in the summer, with the Diabetes Cycle of Care commencing in Quarter 4 of this year.
Under the new arrangements, an additional 270,000 children under 6 will benefit from GP care free at the point of service. All children under 6 will benefit from the new enhanced service under the proposed GP contract. This will involve age-based preventive checks focused on health and wellbeing and the prevention of disease. These assessments will be carried out when a child is aged 2 and again at age 5, in accordance with an agreed protocol.
The contract will also include an agreed cycle of care for children diagnosed with asthma, under which GPs will carry out an annual review of each child where the doctor has diagnosed asthma. The asthma cycle of care will provide the key elements of best practice in the care of asthma with structured visits including education of child and parents, medicine and inhaler technique review and an individualised asthma plan for parents. It will result in better quality of life for children, with resulting better health and wellbeing and less need to visit hospital. The new expanded GP service will apply to all children aged under 6, including those who already have a medical card.
The extension of GP care free at the point of service to everyone aged 70 or over and who does not currently qualify for this benefit will take effect at the same time as the under-6 service, subject to the enactment of the necessary legislation. This service will benefit about 36,000 new patients.
The Diabetes Cycle of Care will enable patients with a medical card or GP visit card and who have Type 2 Diabetes to avail of two annual visits to their GP practice for a structured review of their condition. This initiative will help to integrate care across the continuum of care, will improve clinical outcomes for patients and reduce complications often experienced with this condition.
In addition to the above, the HSE's 2015 National Service Plan has committed to a number of Chronic Disease Management initiatives as follows:
- It is planning to align the existing 10 primary care diabetes initiatives to the Diabetes Model of Care with the support of the Clinical Programme and augment existing podiatry services to deliver the model of care.
- It is also planning to undertake Chronic Disease Integration and Self Care Demonstrator Projects to provide proof of concept of integrating chronic disease services for Asthma, COPD and heart failure between Primary and Secondary Care, with particular focus on the education of practice nurses and local GPs.
Furthermore, a Memorandum of Understanding signed in February 2015 committed the Department of Health, the HSE and the IMO to substantive negotiations on a new comprehensive GP contract. A priority of these discussions, which have commenced, will be the inclusion of chronic disease management for patients over and above the initiatives outlined above.
