Press Release

Minister welcomes progress on 70% of targets for National Health Strategy at Consultative Forum

The Minister for Health and Children, Micheál Martin, today (11 November 2002) welcomed the fact that work had already begun on over 70% of the 121 actions as laid out in the Government´s Health Strategy launched in November 2001. Speaking at a review of the Strategy with the National Consultative Forum in Dublin Castle, he said that much of this progress has been achieved through a greater sense of partnership throughout the health system.

“This partnership is a partnership with all of the stakeholders. Not only are we doing the right thing – we´re doing it in the right way. We´re doing it through consultation, through innovation, through partnership.”

The one-day forum – promised as part of an annual review under the Health Strategy – invited all stakeholders in the health system to assess what actions have begun and to plan for the coming year and beyond.

The Consultative Forum, chaired by Dr. Danny O´Hare, heard from a panel of speakers from health boards and the voluntary sector about the changes that had occurred in the last year, and how this had benefited patients and their families. The afternoon workshops and plenary sessions focussed on the challenges ahead and establishing priorities for implementation at national and regional level in the coming year

In his speech, the Minister said that a number of targets had already been met.

“The Health Strategy had promised to provide 450 public beds during 2002. By the end of the year, we´re on target to have 600 in place – all of them designated for public use only. 109 more will be in place early next year,” he said.

The Forum heard that day case surgery now accounts for about 50% of all elective surgical admissions to acute hospitals. This means that 1 out of every 2 people checking into an acute hospital for elective surgery will be in their own home by the end of the day. This increase has contributed to an increase in overall acute hospital activity of 17% over the last five years.

“It´s an oddity of the health service that significant increases, not just in capacity, but also in delivery, don´t generate the same recognition. The fact is that an enormous increase in throughput has been achieved, with enormous credit to those delivering services,” commented Minister Martin.

Consultative Forum 2

The Minister went on to say that one of the major innovations in the last year was the establishment of the Treatment Purchase Fund. Even allowing for the time required to set up the Team and research the best practices for its operation, it had already had a positive impact on waiting lists.

1,000 people waiting for more than 12 months have now had operations and by the end of the year, more than 1,900 will have been treated. This will contribute significantly to reducing hospital waiting lists in the next twelve months. They stood at 24,850 at the end of June of this year. This represents an overall decrease of 1,809 – that´s 7% – relative to the comparable figure for 2001. (The 7% reduction took place before the Treatment Purchase Scheme was up and running.)

Commenting on the changing economic conditions, the Minister acknowledged that whilst there is a tighter fiscal situation, that didn´t necessarily mean that key elements of the Strategy would be threatened. Innovative Public/Private Partnership initiatives could be both effective and cost-effective in delivering new services, he said.

He also pointed out that some elements of the strategy don´t require substantial amounts of funding.

“Progress on proper complaints procedures in hospitals, which make a real and immediate difference to the experience of patients, doesn’t cost any extra money. Neither does it cost money to make sure outpatients are seen at the time their appointment says they´ll be seen. It doesn´t cost money, but it makes a huge difference. Being one of a large number of patients instructed to turn up at 10 o´clock, only to find you’re not seen until noon, can be bitterly demeaning to an individual. Ten o´clock should mean ten o´clock,” he declared.

Primary Care was another area where significant steps had been taken. October 2002 saw the establishment of €8.4m in funding for ten implementation projects – in Dublin, Cavan, Donegal, Kerry, Laois, Limerick, Tipperary, Mayo and Wicklow. The projects will put a primary care team into each of these locations. The co-located teams include general practitioners, nurses/midwives, health care assistants, home helps, an occupational therapist, physiotherapist, social work and administrative personnel.

“This is going to fundamentally change the nature of primary care delivery. And this is an area where we can confidently and happily raise expectations. Bringing this wide range of service providers together in primary care teams is going to allow us to deliver integrated services faster, more locally, in a more patient-friendly way”, said Micheál Martin.

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Human resources are a key element of the Government´s Health Strategy and the National Task Force on Medical Staffing is charged with examining the implications of introducing a consultant-provided service and of reforming the deployment of Non-consultant hospital doctors to meet EU requirements on working hours. The Minister thanked the Task Force for the work it had done to date and emphasised that it will not be sufficient simply to look at the number of medical staff. The Task Force must also consider delivery of services throughout the hospital system and have full regard to the interactions with primary care and long-term care services.

In his conclusion, Minister Martin spoke about the need for system-wide change and this required reflection about the structures, functions and processes in the health system. He said that an audit of the system had begun and the report by consultants would provide an analysis of key findings, recommendations for system changes, a high level implemen-tation plan and a timetable to take recommendations forward.

“I have met directly with the project consultants to assure them of my personal commitment to consider radical reform, if that is what is required. I have asked them to genuinely critique the system and to seek out the best model for delivering on the agenda that we have set ourselves. I look forward with great interest to their report,” he concluded.