Delivering the Reform Programme

The Programme for Government promises the most fundamental reform of our health services in the history of the State.  Future Health – A Strategic Framework for Reform of the Health Service 2012 –2015 details the actions that we will take to deliver on this promise.

The need for change in the health service is unquestionable.  The current system is unfair to patients; it often fails to meet their needs fast enough; and it does not deliver value for money.  The system is facing major challenges including significantly reducing budgets; long waiting lists; capacity deficits; an ageing population; and a significant growth in the incidence of chronic illness.  It is simply not possible to address these challenges within the confines of the existing health system. We must implement large-scale change that delivers fundamental reform.

The core of the Government’s health reform programme is a single-tier health service, supported by Universal Health Insurance (UHI) and designed in accordance with the principles of social solidarity.  This will mean that:

  • the population will have equal access to healthcare based on need, not income;
  • everyone will be insured for a standard package of curative health services;
  • there will be no distinction between “public” and “private” patients;
  • we will introduce universal primary care, with GP care free at the point of use for all;
  • universal hospital care will include independent, not-for-profit trusts and private hospitals;
  • social care services will be outside of the UHI system but integrated around the user;
  • the health system will be based on a multi-payer insurer model, with competing insurers; and
  • the service will remain, fundamentally, publicly provided.

While the reforms envisaged are comprehensive and transformative, we must maintain access and quality during the reform process.  For this reason, Future Health proposes that change will be implemented in a step by step manner, on the basis of good evidence. Further detailed actions will be built on the foundations of this strategic framework as the reform process proceeds.

We established the Programme Management Office (PMO) to drive, manage and monitor implementation of the reform programme in the Department to act as a central, overarching, co-ordination function for health reform.

The PMO is responsible for:

  • ensuring that all of the various work strands pull together to achieve the overall reform objectives;
  • taking a strategic view on the timetabling and sequencing of the work strands,communication, monitoring and control activities for the programme.

We  work closely with all of the main stakeholders in the health system to ensure successful, collaborative implementation.

Health Reform Programme — Summary of achievements in 2013

In November 2012 the Irish Government approved Future Health: A Strategic Framework for Reform of the Health Service 2012-2015 which set out the main healthcare reforms that would be introduced in the coming years, as key building blocks for the introduction of Universal Health Insurance in 2016. The following is a summary of the main progress to date:

  •  a Health Reform Board, a Programme Management Office in the Department and a Systems Reform Group in the HSE were established to drive implementation of the Health Reform Programme;
  • two reports on Hospital Groups — The “Establishment of Hospital Groups as a Transition to Independent Hospital Trusts”, and “Securing the Future of Smaller Hospitals” were published in May 2013;
  • the Healthy Ireland Policy initiative/Health and Wellbeing Policy was published in March 2013;
  • the Health Service Executive (Governance) Act came into operation on 25 July 2013. The Act abolished the HSE Board and provided for a Directorate to be the governing body for the HSE in place of the Board;
  • work on the National Children’s Hospital began in 2013;
  • a draft of the White Paper on Universal Health Insurance was completed in November 2013; and
  • shadow funding for selected hospitals under “Money Follows the Patient” (MTPF) commenced in 2013.