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Strategic Framework for Reform of the Health Service

Dr Ambrose Mc LoughlinSecretary General

Department of Health

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Driving the changes with a major cost reduction agenda and higher demands for public services

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Context of change

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The Vision

a single tier health system, supported by universal health insurance, where access is based on need, not income

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There is a Plan

Future Health

Health and Well Being

Service Reform Structural ReformFinancial reform

Dr. Ambrose Mc Loughlin, Secretary General, department of Health

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Principles of Reformed System

Keeping People Healthy

Empowerment

QualityEquity

Patient-centredness

Efficiency and Effectiveness

Regulation and Patient Safety

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The Time Frame

Q1 2013

Q2 2013

Q3 2013

Q4 2013

UHI: Preliminary paper ppublished in February. UHI Design Team to be established Money Follows the Patient: Policy paper published in Febuary & stakeholder consultation

process commenced. HSE Project Manager and HSE National Leads for Pricing,

Commissioning and Hospital Support will be assigned and MFTP Oversight Group will be established

External State of Readiness Report for roll-out of MFTP will be completed

Permanent Scheme of Risk Equalisation: In place in January.

Hospitals: Report on Hospital Groups and Smaller Hospitals Framework will

be submitted to Government shortly.

UHI: Policy appraisal of UHI Models will be completed.

Money Follows The Patient: Policy proposals will be developed for introduction

of case based charges for private patients in public hospitals.

Review of HSE Integrated Service Areas: Review to be completed to (i) ensure maximum

alignment between all service providers at local level (ii) review executive management and government arrangements and (iii) inform new structures for the delivery of Primary Care.

UHI: Paper on Macro Level Funding Flows will completed. Legal Appraisal of UHI Models will be completed.

Money Follows The Patient: National Casemix Conference to be held in April as key

element of stakeholder consultation. Shadow Based Budgeting to commence.

Extension of Free GP Care to Persons with Prescribed Illnesses: Bill to be published.

UHI: Policy papers will be completed on (i) Basket of Services

and (ii) Funding & Financial Support Services.

Money Follows The Patient: Detailed Implementation Plans progressed for ‘go live’ from

2014.

VHI: Regulatory status of the VHI will be addressed in line with

ECJ ruling.

Health Information Bill: Preparation work completed to allow publication of Bill.

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The Process

Programme Board

Programme Management Office• Department of

Health

SystemsReform Function • HSE

Programme Management & Collaboration Strengthens Capacity to Move Swiftly

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Patients First

Healthy Ireland A Framework for

Improved Health and Wellbeing

A Whole of Government Approach

PatientSafetyAgency

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The Plan is Working

• This year to date 14.7% less patients waiting on trolleys compared to 2012

• No of adults waiting more than 9 mths for inpatient and day case surgery was down to 86 at end of December 2012

• No of children waiting over 20 weeks was down to 89 at end of December 2012

• No of patients waiting over 13 weeks for routine GI endoscopy was down to 36 at end of December 2012

• THIS IS REAL PROGRESS

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Building the Foundation

Legislative Reform

Health Service (Executive) Governance Bill 2012The Health (Pricing and Supply of Medical Goods) Bill 2012Health Amendment Bill (No 3) Return of vote to Department of Health

Legislative Reform

Policy PapersMoney Follows the Patient Policy Paper Published 15 February 2013The Path to Universal Healthcare Published 15 February 2013

Leading to White Paper on Universal Health Insurance

12/04/2023 Dr. Ambrose Mc Loughlin, Secretary General, department of Health

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We can Show Results

Financial ReformThe roll-out of a comprehensive financial management system is a priority for the Department and the HSE in 2013.Shadow Funding will commence in 2013 with go-live in 2014New Risk Equalisation Scheme approved by European Commission

Structural ReformThe Establishment of Hospital Groups as a Transition to Hospital Trusts GroupsSecuring the Future- Framework for Smaller HospitalsHSE Directorate Structure underwayISA Review about to commence

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Real Reform

Reforming Primary Care• Introduction of a new contract for GP’s emphasis on chronic disease

management• Bill to allow for extension of free GP care to persons with prescribed

illness due to be published later this year.• €20 million available to recruit front line primary care teams (250

posts)• Major capital plan to be announced by Minister shortly. Will provide

for 43 Primary Care Centres by various means.• New Paediatric Hospital underway

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Reforming Social & Continuing Care

• A National Implementation Framework for the Value for Money Review of Disability Services Published in February 2013 and Oversight Board established

• € 70m allocation to strengthen community based mental health services• National Positive Ageing Strategy to be published shortly• Single Assessment Tool for Older People in development• Review of Nursing Home Support Scheme to start shortly• Review of the status of Public Nursing Homes by HSE complete and will form

the basis of future proposals to maximise the number of units retained within existing resources

Real Reform

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Outcomes for All

Improved Health and Well being

Faster Fairer

Access to Hospitals

Free Access to GP Care

Better Management

of Chronic IllnessMore

People Cared for in their Homes

Improved Quality

and Safety

Affordability

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Conclusion

Dr. Ambrose Mc Loughlin, Secretary General, Department of Health

Most comprehensive reform since foundation of State

Good progress to date the reforms are working

We need to build on our success