In Case You Missed It – Developments in Health Policy during 2018
31st December 2018
Over the past twelve months the Department of Health has developed a range of policies and regulations to improve our overall Health Service.
Below is a list of some developments made over the course of 2018.
A Trauma System for Ireland: Estimates suggest Ireland is likely to have 1,600 major trauma cases per year. Currently, significant numbers of major trauma patients go to hospitals that cannot provide necessary and definitive care.
In February 2018, the Report of the Trauma Steering Group, ‘A Trauma System for Ireland’ was published. This report aims to reduce the incidence and the burden of trauma and to significantly improve the survival rate of major trauma patients, by ensuring that every patient receives the best possible standard of care in the most appropriate facility.
It addresses the entire care pathway from prevention through to rehabilitation, and recommends the establishment of an inclusive trauma system with two hub-and-spoke trauma networks, two Major Trauma Centres and up to 13 trauma receiving hospitals.
An interim implementation group has been established by the HSE, as recommended in the report, and is progressing the four immediate actions (orthopaedic bypass protocols, selection of Major Trauma Centre for Dublin, recruitment of National Clinical Lead and detailed implementation planning).
The Trauma System for Ireland will enhance the chance of survival and lead to better patient outcomes by making sure that those who need care get the right care, at the right time.
“The HSE has launched a consultation process on the proposed draft Service Specifications for Major Trauma Centres and Trauma Units, and the proposed approach and process to designate the Central Trauma Network’s Major Trauma Centre and Dublin Trauma Unit(s). For more details see here.
For further information; https://health.gov.ie/blog/press-release/minister-for-health-joins-stakeholders-to-formally-launch-a-trauma-system-for-ireland-and-confirm-inclusion-of-trauma-system-capital-investment-in-project/
ORKAMBI: On 15th March 2018, Minister for Health Simon Harris announced that Ireland would become one of the first countries in the European Union to provide access to ORKAMBI for children aged 6-11 years old. ORKAMBI was already licenced and available for reimbursement for children aged 12 years and over.
The extension to younger children became possible following EMA approval in January 2018. This quick turnaround between approval and availability was possible because we ensured the younger age group was included in the agreement with the company Vertex last year, subject to market authorisation in Europe.
For further information; https://health.gov.ie/blog/press-release/good-news-for-cystic-fibrosis-patients-and-their-families-with-the-extension-of-orkambi-availability-to-children-aged-6-11-years-minister-harris/
April/ May 2018
Sugar Tax: On Tuesday 24th April 2018, the European Commission found Ireland’s proposed sugar-sweetened tax did not constitute State aid, paving the way for the commencement of the ‘Sugar Tax’ on May 1st 2018.
This move represented a major progress under Healthy Ireland towards tackling obesity. With 1 in 4 children on the island of Ireland either overweight or obese, this tax is one of a range of measures that can help change parents’ and children’s behaviour. There is no nutritional value in these sugar-sweetened drinks and it has been proven that the intake of these beverages, particularly in children, leads to weight gain and tooth decay.
The tax was estimated to yield in the region of €40m in a full year, however, it is expected that as industry reformulates and consumers opt for healthier options this figure will reduce over time.
For further information; https://health.gov.ie/blog/press-release/government-welcomes-european-commission-approval-of-sugar-sweetened-drinks-tax/
Regulation of Counsellor and Psychotherapist Professions: In May 2018, Minister Harris signed regulations to designate counsellor and psychotherapist as professions to be regulated under the Health and Social Care Professionals Act 2005.
The regulation of these professions ensure greater protection of the public, compliancy with a code of professional conduct and ethics and those registered will be subject to fitness to practice.
Only those registered will be entitled to use the title or titles protected under the Act. Registrants will be subject to a range of sanctions (including suspension or cancellation of registration) in the case of a substantiated complaint of professional misconduct or poor professional performance.
Decision to regulate the professions of counsellor and psychotherapist came on foot of consultation with the Health and Social Care Professionals Council, followed by a wider public consultation.
For further information: https://health.gov.ie/blog/press-release/minister-harris-signs-order-to-regulate-professions-of-counsellor-and-psychotherapist/
In-patient/ Day Case Waiting List: 2018 has seen considerable improvements for patients accessing inpatient and day case procedures in our public hospitals.
An ambitious Inpatient Day Case Action Plan 2018 was published in April.
In November, the National Treatment Purchase Fund met its key target under the Action Plan, to arrange an inpatient or day case treatment for 20,000 patients this year. Overall. this year has seen, on average, almost 12,000 patients coming off our inpatient/day case waiting list each month as a result of the activity of the HSE and NTPF.
Budget 2019 announced that the Government had further increased investment in tackling waiting lists, with funding to the National Treatment Purchase fund (NTPF) increasing from €55 million in 2018 to €75 million in 2019. Through the activity of the HSE and NTPF, the number of patients waiting for a hospital procedure is projected to fall to below 59,000 by the end of 2019.
For further information: https://health.gov.ie/blog/publications/inpatient-day-case-action-plan-2018/
BeNeLuxA: On 22nd June 2018, Ireland became a member of the Beneluxa Initiative on Pharmaceutical Policy. Minister Harris signed an agreement to work with Austria, Belgium, the Netherlands and Luxembourg to secure affordable and timely access to new medicines for Irish patients.
The objectives of BeNeLuxA are as follows;
- Enhance patients’ access to high quality and affordable treatments
- Improve the payers’ position in the market through joint negotiations
- Increase transparency on pricing between collaborating countries
- Share policy expertise
- Enable national health challenges to be anticipated more effectively through the use of horizon scanning
The collaboration assists us in sourcing medicines which are affordable and sustainable in the context of the competing demands for resources across our health service.
For further information; https://health.gov.ie/blog/press-release/minister-harris-signs-international-agreement-aimed-at-securing-affordable-and-timely-access-to-new-medicines-for-irish-patients/
HPV Vaccine: Following the launch of HPV Vaccine programme for girls in 2017, the Department of Heath, HSE, medical professionals, politicians and health correspondents contributed to the HSE’s #ProtectOurFuture campaign.
The campaign aimed to provide accurate and credible information about the HPV vaccine.
In July 2018 Minister Harris commended the progress this HSE campaign made; “The uptake rate of 65% is a significant improvement on 51% the previous year and, a step in the right direction, to the average of 87% we had not too long ago”. The Minister particularly commended Laura Brennan for her selfless advocacy for the HPV immunisation programme.
In December 2018 it was announced that the HPV Vaccination programme would be extended to boys, following HIQA review that confirmed the proposed extension of the HPV vaccination programme to boys will be both clinically and cost effective. The Department of Health will work to progress these plans in 2019.
1 in every 20 cancer cases in the world is due to HPV. Vaccines save lives.
For further information; https://health.gov.ie/blog/press-release/minister-for-health-launches-hpv-vaccine-information-campaign/
https://health.gov.ie/blog/press-release/minister-for-health-launches-hpv-vaccine-information-campaign/ // https://health.gov.ie/blog/press-release/minister-harris-launches-hpv-vaccination-campaign-and-tells-scaremongers-to-butt-out-and-leave-medical-advice-to-medical-professionals/ // https://health.gov.ie/blog/press-release/minister-harris-welcomes-hiqa-recommendation-to-proceed-with-hpv-vaccine-for-boys/
Personalised Budgets: In July 2018, Minister McGrath launched the report of the Task Force on Personalised Budgets. The report sets out how personalised budgets could work as a funding mechanism for people with a disability, providing them with greater choice and control over the services and supports they receive.
The Department of Health, NDA and the HSE are in the process of designing demonstration projects, as recommended by the Task Force on Personalised Budgets, which will be rolled out in 2019.
For further information: https://health.gov.ie/blog/press-release/minister-mcgrath-launches-the-report-of-the-task-force-on-personalised-budgets/
Personal Possession of Illegal Drugs: A Working Group was established under the national drug strategy ‘Reducing Harm, Supporting Recovery’ to examine alternative approaches for the possession of illegal drugs for personal use.
To help inform their deliberations, the Department launched a public consultation to gather views on the effectiveness of the current law and on what alternatives could be considered.
A record breaking 20,650 submissions were made. The responses will help inform the deliberations of a working group, established under the national drug strategy ‘Reducing Harm, Supporting Recovery’, who are currently examining alternative approaches for the possession of illegal drugs for personal use.
Public Consultations are an important part of policy development. The Department is grateful to all citizen’s, stakeholders and representation groups who consulted with us during 2018.
For further information; https://health.gov.ie/blog/publications/reducing-harm-supporting-recovery-2017-2025/
Scoping Inquiry into CervicalCheck: On 12 September 2018, the Report of the Scoping Inquiry into the CervicalCheck Screening Programme, led by Dr Gabriel Scally, was published following a Government decision. While the Inquiry was satisfied with the quality management processes in the laboratories currently providing screening, Dr Scally’s report made 50 recommendations for improvement across a range of areas. Government accepted all 50 recommendations and on 11 December 2018, the Implementation Plan for Dr Scally’s Report was published. The Implementation Plan sets out 126 actions addressing Dr Scally’s recommendations, across the areas of women and women’s health, organisation and governance, laboratory services and procurement, open disclosure, cancer registration, other screening programmes and resolution.
The development of the Plan was overseen by the CervicalCheck Steering Committee, established by the Minister in June 2018 to provide oversight and assurance in relation to managing the response to the CervicalCheck issues, and ensure the implementation of the key decisions taken by Government.
While screening alone cannot prevent all women getting cervical cancer, a well organised screening programme, when combined with HPV vaccination for boys and girls, can make cervical cancer a rare disease. In parallel with the implementation of Dr Scally’s recommendations, work is underway on the implementation of the switch to HPV testing as the primary screening test, in tandem with the extension of the HPV vaccination to boys.
For further information:
Standardised Cigarette Packaging: From September 2018, all cigarettes and other tobacco products were to be sold in plain or standardised packaging in accordance with the Public Health (Standardised Packaging of Tobacco) Act 2015. Gone are the familiar colours and logos of the various brands and instead all cigarette boxes are to be presented in the same plain neutral colour, bringing into sharp focus public health warnings on the packets.
Standardised packaging is just one of a number of measures outlined in ‘Tobacco Free Ireland’ the ultimate aim of which is to encourage and help smokers to quit and to prevent young people from starting to smoke.
According to the Healthy Ireland Survey 2018, there are an estimated 80,000 fewer smokers in Ireland today, than there were 3 years ago. In the last 12 months 40% of smokers have made an attempt to quit, with some citing plain packaging with health warnings a positive motivation.
For Further Information: https://health.gov.ie/wp-content/uploads/2014/03/TobaccoFreeIreland.pdf
October/ November 2018
Women’s Health Action Plan: During his Budget Speech, Minister for Health Simon Harris announced the development of a ‘Women’s Health Action Plan’ in 2019. The Department of Health, HSE and National Women’s Council of Ireland have begun work on the development of a Women’s Health Action Plan, as recommended in the National Women and Girls’ Strategy.
This plan will identify key actions to address the particular physical and mental health needs of women and girls, and integrate these into existing and emerging health strategies, policies and programmes.
For further information: https://health.gov.ie/blog/speeches/women-making-history-national-women-council-of-ireland-agm-speech-by-minister-for-health-simon-harris-td-thursday-21-june-2018/
Winter Plan: On 6 December, Minister for Health, Simon Harris TD and Minister for Older People, Jim Daly TD welcomed the publication of the HSE’s Winter Plan 2018/19. The plan represents a system wide response to the challenges experienced across the health service during the winter period. It includes a four week period of focused action from 17 December until 13 January. During this period, 9 key hospital sites, the Mater, St. Vincent’s, Tallaght, Naas, Tullamore, Galway, Limerick, Cork University Hospital, University Hospital Waterford and their associated community health organisations are being targeted with a suite of enhanced actions.
The HSE plan optimises the use of existing resources and provides an alternative for patients to the Emergency Department, including extended opening hours and expanded services at local injury units, minor injury units and key Primary Care Centres. In addition to the optimisation of existing resources, the HSE is investing an additional €30m specifically in winter initiatives. The NTPF has established a fund of €1m, which will support the HSE Winter Plans, with a focus on increasing access to diagnostics in both private facilities and in-house.
After a challenging year for our health services, marked by high Emergency Department attendances earlier in 2018 due to Storm Emma, trolley numbers have fallen month on month, with the exception of November, from May 2018 onwards. December 2018 also saw a sharp decline of 19.2% in the number of patients waiting on trolleys at 8am, as compared to December 2017, with the 8am trolley count at the end of 2018 coming in at 98,136, a 1.8% increase on 2017.
For further information: https://www.hse.ie/eng/services/news/media/pressrel/hse-announces-winter-plan-2018-2019.html
Autism Plan 2019: On 5th December 2018, the roll-out of a new autism plan was announced. Two reports were published on this day, detailing the prevalence of autism in Ireland and reviewing the services for people with autism.
Drawing on a variety of sources, the research report concluded that there is a robust case for estimating a prevalence rate of autism in children of 1-1.5% for the purposes of planning policy and services in Ireland. This is similar to the most recent reported prevalence rates in countries such as Denmark, Finland, Norway, Sweden, Italy, UK, Italy, USA, Canada and Australia.
The HSE will now proceed with the implementation of the recommendations in the review report. This commitment will be reflected in the HSE National Service Plan for 2019 and will form part of an overall Autism Plan to be published in 2019.
For further information: https://health.gov.ie/blog/publications/reports-on-the-prevalence-of-autism-in-ireland-and-a-review-of-the-services-for-people-with-autism/
Notes to the Editor
Department of Health information sources:
Publications – https://health.gov.ie/publications-research/publications/
Press Releases – https://health.gov.ie/news-centre/press-releases/
Speeches – https://health.gov.ie/news-centre/speeches/
Noticeboard – https://health.gov.ie/news-centre/notice-board/
Twitter – @RoinnSlainte