Health Reform Alliance calls for expansion of entitlements in Budget 2018

The Health Reform Alliance has today outlined a number of key areas of investment aimed
towards expanding health and social care entitlements. The alliance of health and social
care charities has called for investment in ‘cradle to grave’ care that looks after everyone
in Ireland.

Paul Gordon, co-chair of the Health Reform Alliance said: “In Budget 2018, the
Government needs to make a statement of intent that shows it is serious about health and
social care on the basis of need and not the size of your pay packet. The Taoiseach and
Minister for Health have spent recent months lionising the Sláintecare report and now the
Government has to put its money where its mouth is.”

The Sláintecare report, which was published with cross-Party consensus in June, sets out a
ten year plan to progress to a system of universal healthcare. Its implementation office
will be set up by the end of the year, but the Alliance believes momentum needs to gather
before then.

Kathryn Reilly, co-chair of the Alliance said: “A delay in setting up the implementation
office was disappointing and to maintain the momentum generated by the report’s
publication in June, we need to see targeted investment in a number of areas to ensure
that everyone in Ireland sees the benefits of the report”.

Mr. Gordon added that: “While we recognise the limited room for manoeuvre in terms of
money available in this Budget, the Government must use the available space of circa
€118million within the health vote’s current expenditure ceiling for 2018 to prioritise
expansion of entitlements in certain areas”.

“Ultimately, Budget 2019 will act as the litmus test for Sláintecare as the fiscal space
expands, and as the Implementation Office further develops its implementation planning.
However, we believe the expanded expenditure ceiling for 2018 should be used to invest
in ‘cradle to grave’ care that benefits people of all ages.”

Ms. Reilly said: “We are calling for investment in our children’s health and wellbeing, the
reduction of out of pocket payments which rose exponentially over the course of the
recession, the expansion of diagnostics into the community, additional investment in
much-needed homecare, and the expansion of services for people with disabilities.”

The Health Reform Alliance is calling for Minister Paschal Donohoe to earmark the
following areas for investment:

  • €8.3million to resource and develop a child health and wellbeing service
  • €25million to abolish hospital inpatient charges €25 million to expand diagnostics into primary care settings
  • €24 million to expand homecare
  • €29 million to improve and expand services for people with disabilities
  • €8million in increased expenditure on palliative care

Total: €119.3 million*

Ms. Reilly said: “The Health Reform Alliance supports Sláintecare because it wants a
health and social care system that is focused on the needs of all social groups. We
recognise that all the measures targeted for year one in the Sláintecare report may not
happen this year due to budgetary restrictions, but we need to make a start and we
believe our proposals will improve the lives of children, families, young people, older
people and people with disabilities or impairments, and people at the end of life.”

The Health Reform Alliance has previously spoken on the need for continued engagement
by all political parties to keep Sláintecare on the policy agenda.

Speaking on the publication of a number of alternative budgets, Paul Gordon said: “We are
heartened by the fact that a number of Parties’ alternative Budgets have included significant commitments to, and investments in, Sláintecare. The Cross-Party consensus
that was forged in the report needs to be carried on so that Sláintecare forms the bedrock of healthcare policy for the next ten years.”

* All of these measures were costed in the Sláintecare report.

Health Reform Alliance Disappointed at Missed Sláintecare Deadline

Health and Social Care Charities call for Implementation Office to be set up without delay

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The Health Reform Alliance, a coalition of charities across the health and social care sector, has expressed disappointment as the first landmark deadline of the Sláintecare Report, the establishment of an Implementation Office in the Department of the Taoiseach by the end of July, has passed without any tangible action.

Paul Gordon, Chairperson of the Alliance said: “Despite the priority given to the Sláintecare Report by the Taoiseach following his appointment in June, there is neither sight nor sound of the proposed Implementation Office or of the Minister for Health’s detailed response to the Report.”

The Future of Healthcare Committee proposed setting up an Implementation Office under the auspices of An Taoiseach by the end of July 2017.

“This is the first landmark in the report by the Committee on the Future of Healthcare that has been missed, and we’re disappointed that reform of the health and social care system has fallen further behind already.”

Mr. Gordon said the Sláintecare Report is “a once-in-a-generation opportunity to offer meaningful reform, but it will falter without strong support. Leadership from the very top of Government will be needed if we want to succeed in delivering a health system focused on caring for all groups in our society. As a first step, the establishment of an Implementation Office, without further delay, would be a real statement of intent.”

In June, the Taoiseach tasked the Minister for Health with preparing a detailed response to the report, but this has yet to be presented to Cabinet.

Kathryn Reilly, also speaking on behalf of the Alliance, said: “We await the Minister for Health’s response with interest, and welcome the Taoiseach’s recent acknowledgement of the need to disentangle the public-private mix in our hospitals. However, to ensure real progress towards a single-tier system of healthcare that works for everyone in Ireland, the Government must avoid picking and choosing recommendations á la carte.”

“The Cross-Party consensus reached on the Future of Healthcare in drafting the Sláintecare Report, needs to be realised through its full implementation. Piecemeal change, based on political patronage and electoral cycles, has failed us in the past. The establishment of an Implementation Office will represent a good start, and can hopefully develop a roadmap to a single-tier system.”

 

Policy Forum update

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We at the Health Reform Alliance want to thank everyone who attended our ‘Policy Forum’ on the Future of Healthcare and the Sláintecare Report last Thursday. We were delighted so many of you were able to attend and hope this is reflective of a desire across various stakeholders groups for real change!

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We’d also like to thank all our speakers – Susan Mitchell, Róisín Shortall TD, Dr. Ronan Fawsitt and Dr. Anthony Staines – for their very interesting and engaging contributions. Below you’ll find a brief recap on the event, with slides from Drs. Fawsitt and Staines included.

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Time for a quick cuppa before kicking things off

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Deputies Róisín Shortall, Michael Harty and Dr. Ronan Fawsitt share a laugh

After a short welcome from Health Reform Alliance Chairperson, Paul Gordon, Susan Mitchell, Health Editor at the Sunday Business Post, chair of the ‘policy forum’, introduced the day and gave an overview of her experiences of the health and social care services as a journalist, and the need for change.

L to R: Dr Anthony Staines, Róisín Shortall TD, Susan Mitchell, Dr. Ronan Fawsitt

L to R: Dr Anthony Staines, Róisín Shortall TD, Susan Mitchell, Dr. Ronan Fawsitt

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Deputy Róisín Shortall delivered the keynote speech at the event, giving her insights into why the Future of Healthcare Committee was needed and how it was established, offering commentary from her time as Chair of the Future of Healthcare Committee, including key learnings from Committee hearings and work with colleagues on the Committee, as well as looking to the future and giving her view on what is needed across the various stakeholders to ensure implementation of the Sláintecare report.
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Dr. Ronan Fawsitt, GP and chair of the ICGP-St.Luke’s Local Integrated Care Committee (LICC), delivered an insightful presentation, focusing on his own experience as a GP, and as chair and co-founder of the Carlow-Kilkenny LICC, discussing the need for a ‘paradigm shift’ to deal with increasing demand and an ageing population, the role of general practice and the need for integration of care.

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Dr. Anthony Staines, professor of Health Systems at Dublin City University, posed a number of questions around our health and social care services, trying to envisage what a ‘good’ system would look like, what’s required from various sectors in society for real change to happen, examining the best model of care and the role of primary and integrated care, along with looking at next steps.

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Susan Mitchell chaired a panel discussion which covered a range of topics, focusing on potential roadblocks to implementation of reform and the Sláintecare report. This was followed by a very engaging Q&A discussion, thanks to the wide-ranging representation of groups present, who offered unique perspectives, highlighting challenges for Sláintecare.

Thanks to all for coming and we hope you enjoyed the event.

We look forward to seeing you again soon!

 

 

 

 

 

Future of Healthcare Policy Forum – Full programme

The Health Reform Alliance’s ‘Future of Healthcare – Policy Forum’ will take place on Thursday, 29th June from 10am to 12.30pm in the Woodquay Venue, Civic Offices, Wood Quay, Dublin 8.

You can sign up to attend here and if you have any questions about the event or the Health Reform Alliance, please contact info@healthreformalliance.ie.

The day will focus on the Sláintecare report, how our speakers see it working in practice, how it will be implemented and if it will lead to a more equal health and social care system that ensures different aspects of the system work together, ensures significantly expanded entitlements, and whether it will help meet our five principles for reform.

Registration will begin at 10am with light refreshments, and proceedings will commence at 10.30am sharp.

Following a short welcome from the Health Reform Alliance, compère for the day, Susan Mitchell, journalist and Health Editor at the Sunday Business Post will kick off proceedings, with introductory remarks and some reflections on past failures of our health system from her perspective as a journalist, and her thoughts around implementation of the report.

Róisín Shortall TD, co-leader of the Social Democrats and Chair of the Oireachtas Committee on the Future of Healthcare will deliver the keynote address, which will include commentary on her time chairing the Committee and what is needed from various stakeholders to help progress the Sláintecare report.

Dr. Ronan Fawsitt, a full-time GP and Chair of the Carlow-Kilkenny ICGP-St Luke’s Hospital Local Integrated Care Committee (LICC), will speak about his experience developing the Carlow/Kilkenny model of integrated care and will examine whether the report will ensure the different elements of the health and social care system work together in a more integrated way.

Dr. Anthony Staines, a professor of Health Systems at Dublin City University, who also currently chairs the Irish Blood Transfusion Service, will discuss implementation of the report and the intersection of policy and politics.

This will all be followed by a panel discussion, which will incorporate a questions and answers session from the floor.

Speakers’ biographies:

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Róisín Shortall has been a TD for Dublin North-West since 1992. She is the co-leader of the Social Democrats. Róisín previously served as Junior Minister with Responsibility for Primary Care. She was the chair of the Committee on the Future of Healthcare which was tasked with developing a cross-party consensus on a ten year strategy for delivering a universal single tier health service for Ireland. This was published on 30th May as the Sláinecare report.

 

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Susan Mitchell is a journalist and is currently the Health Editor at the Sunday Business Post.
Susan has won numerous awards for her coverage of Ireland’s healthcare system, including the 2016 NewsBrands Ireland Feature Writer of the Year. Her work includes in-depth reports on the HSE from the frontline to the boardroom, and her stories have led to several national policy changes.
Susan holds a BA from UCD and a postgraduate diploma in business studies from the UCD Michael Smurfit Graduate Business School.

 

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Dr. Ronan Fawsitt is a full-time GP Partner in a large mixed urban-rural practice based in Kilkenny City.
He is Chairman of the Kilkenny Faculty Irish College of General Practitioners (ICGP) and of the Carlow-Kilkenny ICGP-St Luke’s Hospital Local Integrated Care Committee (LICC). He is also Chair of the GP Advisory Group for the Ireland East Hospital Group (IEHG) and serves as Primary Care Lead on the IEHG Executive Management Team. In 2016, he won the first national GP Buddy General Practitioner of the Year Award.
Dr. Fawsitt has been involved in an ongoing collaboration with partners in St. Luke’s Hospital to develop an integrated care model in Carlow/Kilkenny which allows clinicians and management to work together in a formal structure, known as a Local Integrated Care Committee. This liaison structure engages all local parties in the doctor patient process including GPs, Consultants, Public Health doctors, hospital and community management and pharmacists, in order to provide better care pathways for patients into and out of hospital and to facilitate more care in the community in an agreed and resourced manner.

 

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Dr. Anthony Staines is a professor of Health Systems at Dublin City University, and also currently chairs the Irish Blood Transfusion Service.
Anthony began his career as a neonatal paediatrician, before moving into public health and academic epidemiology, receiving an MSc in Epidemiology at the London School and PhD in Spatial Epidemiology at the University of Leeds.
Anthony has undertaken research on child public health, health information systems, the social costs of illness, blood transfusion policy and the financing of primary care systems.
Anthony has been a strong advocate for a fairer, more sustainable health service and ran as an independent candidate for the Seanad in 2016 on the Trinity College panel.

Sláintecare assessment

The Health Reform Alliance welcomed the recent publication of the Sláintecare report and its recommendations, which we described as an ambitious strategy and a once-in-a-generation opportunity to offer meaningful reform.

Our member organisations first came together to seek changes to our health and social care system that ensures:

  • people are treated equally
  • that the system is focused on caring for all groups in our society
  • an entitlement to care, free at the point of access
  • the different elements of the health and social care system work together to provide quality care and;
  • the health and social care system is a universal, publicly funded system

With this in mind, we have assessed the Sláintecare report’s main recommendations against the key principles we set forth in 2015 upon our establishment, which outlined how Ireland’s health and social care system should be reformed.

This short overview looks at the key measures included in the report that may ensure progress on each our our five principles, along with identifying any shortcomings.

You can take a look at our assessment of the report here, and we hope you find it helpful.

 

 

 

Future of Healthcare Policy Forum – Thursday 29 June at 10am

The Future of Healthcare – Policy Forum

The Health Reform Alliance’s ‘Future of Healthcare – Policy Forum’ will take place on Thursday, 29th June from 10am to 12.30pm in the Woodquay Venue, Civic Offices, Wood Quay, Dublin 8.

The Committee on the Future of Healthcare which was established by the Dáil in 2016 with a remit to achieve cross-Party consensus on a single long-term vision of healthcare and health policy in Ireland, published its Sláintecare Report at the end of May. The report sets out a number of recommendations and proposals that will radically change the face of health and social care in the next ten years.

To coincide with the Report’s publication, the Health Reform Alliance will host a policy forum on the report and what it will mean for the future of health and social care in Ireland, if implemented.

The Policy Forum will bring together policy experts, clinicians, representatives from civil society and members of the media with elected representatives who were involved in the development of the Committee’s report. Committee Chair, Róisín Shortall TD, will deliver the keynote address.

It will be an opportunity to have a forward-thinking, challenging and positive discussion about the potential application and implementation of the Report.

If you’d like to attend, please register here.

Full running order to follow…

Health Reform Alliance welcomes Sláintecare Report and calls for public support from FG leadership

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Wednesday, 30 May – The Health Reform Alliance has called on the two Fine Gael leadership candidates to support the Sláintecare Report which urges the scrapping of the two tier health system and promotes access to healthcare on the basis of need, not ability to pay.

According to the Health Reform Alliance (HRA), which brings together voices across the health and social care sectors, the recommendations of the Sláintecare Report launched today represent a “once-in-a-generation opportunity” to end unequal access to health and social care services. However, the Alliance says that leadership from the top of Government and strong political will is critical if progress is to be made.

Chairperson of the Health Reform Alliance, Paul Gordon said: “This is a once-in-a-generation opportunity to offer meaningful reform, and implementation of the report’s recommendations will require strong Government support. Leadership from the very top of Government will be needed if we want to succeed in delivering a health system focused on caring for all groups in our society”.

“The Committee on the Future of Healthcare has worked hard to build cross-Party consensus in a policy area which has often been defined by hotchpotch, piecemeal change. We are calling on Ministers Coveney and Minister Varadkar to be leaders of the change required in the Irish healthcare system by declaring their commitment to establish the proposed Implementation Office within the Department of the Taoiseach by the report’s July deadline”.

Also speaking following the publication of the report, Kathryn Reilly, member of the HRA’s executive, said, “This report provides a clear vision for a system of healthcare that treats everyone equally, and where the ability to pay for care is no longer a matter of life and death. Implementation of the report will bring Ireland’s healthcare system closer to the principles of the Health Reform Alliance which are focused on providing universally available, equitable, needs-focused, health and social care services, and that work for everyone in Ireland.

“Welcome measures include the provision of enhanced universal access to primary care, home care and diagnostics, the extension of essential healthcare in areas such as social care, with a reduction in out-of-pocket expenses for hospital care and medication. Plans to enhance capacity in acute care, to offer universal access to diagnostics and to ensure that care is given at the lowest level of complexity also have the potential to substantially improve outcomes for all.”

Mr. Gordon noted: “The Committee has also made commitments to disentangle private care from the public system, which will be vitally important in making a decisive break with a two-tier system. While the report makes a couple of key recommendations to achieve that, the proposed Implementation Office will need to spell out the process of disentanglement in greater detail.”

The Health Reform Alliance commended the Oireachtas Committee members on their work, and Mr. Gordon hailed the Deputies’ “collaboration not just with each other across party lines, but with various interest groups, to offer a new way of working that will hopefully result in a remaking of our health services for the betterment of the whole of Irish society.”

 

Health Reform Alliance Think-in Report

In May 2016 the Health Reform Alliance (HRA) held in Think-in for those who were interested in learning more about the HRA

  • Principle 4 was voted as the most important principle to attendees.
  • The 5 HRA Principles were well understood. Suggestions were made for ways to refine and clarify the principles such as adding more definitions and distinctions between principles.
  • There was considerable focus on how to implement the 5 HRA Principles. Implementation strategies for individual principles and all 5 HRA Principles together often centred on adoption of a human rights approach (e.g. arguing for a right to healthcare), addressing cultural or attitudinal issues (e.g. identify current attitudes towards the healthcare system and universal healthcare, awareness raising on the benefits of a universal healthcare system), patient or public action (e.g. greater personal responsibility for health, mobilising a grass roots political movement) and institutional actions (e.g. greater interdepartmental and party thinking, longterm, well-resourced, realistic plans, restructuring of the current two-tier system).
  • Ideas for additional principles included a focus on quality of services, effective services and greater emphasis on the role of patients.
  • The 5 HRA Principles will be reviewed by the founding committee in light of the feedback and suggestions made by the attendees at the Think-in. Read more

Health Reform Alliance calls on Future of Healthcare Committee to offer vision for a universal healthcare system

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Leading Irish charities have come together to present a vision for health reform at the first public session of the Oireachtas Committee on the Future of Healthcare, which has been tasked with developing a ten-year plan for the health system.

The Health Reform Alliance expressed the hope that the Committee can help achieve a universal, single-tier health and social care system in Ireland.

Cliona Loughnane, spokesperson for the Health Reform Alliance, said: “This Committee has a rare opportunity to shape health policy for the next ten years and beyond. We hope all members will work together to create the foundations for a health service that treats everyone equally, and where the ability to pay for healthcare is no longer a matter of life and death.”

“Real reform of the health and social care system cannot be achieved within five-year electoral cycles defined by hotchpotch, piecemeal changes. Vision and bravery is now required by all parties to establish consensus as to how to make our health system work best for those who need it most.”

Speaking at the Committee, Paul Gordon, a member of the Alliance’s executive, said: “The fact we are sitting here today reflects the acknowledgement that the partisan discourse of the past must be exactly that. It is incumbent on Committee members that they continue the good work we know they have been doing behind the scenes so far, and continue to collaborate to achieve a vision for a health and social care system we can be confident in.”

The Health Reform Alliance, launched at the beginning of 2016, to help set out a new vision for our health service, sees the main problem with the health system as a lack of universal access to health services.

Ms. Loughnane said: “Unlike the majority of Europe, Ireland has never developed universal access to health services. Our peculiar provision of healthcare is unique. It combines a lack of universal access to care with large out-of-pocket payments, and simply cannot meet the needs of the thousands of people across Ireland who depend on it every day.”

Ms. Loughnane called on committee members to “focus initially on the healthcare system to be delivered for people. Rather than putting the cart before the horse and devising a way to fund a system before deciding what we’re paying for, we’d urge members to consider what outcome we need to achieve.”

“The Health Reform Alliance believes that a reformed system should share the burden of illness collectively, where healthy people subsidise the sick and high income earners subsidise low earners.”

Dr. Marita O’Brien, also presenting on behalf of the Alliance, emphasised the need to design a vision for a health and social care system.

“In our current system, social care is seen as an individual responsibility subject to heavy means-testing. This means a lack of funding set aside for social care which can force families to place a loved one in residential care prematurely, when home help, day-care or respite could have kept them at home.”

“Increasingly, vital social care services are only available to those with the highest needs and lowest incomes, rather than as a universal service supporting the whole population. The divide between health and social care needs to be bridged”.

Acknowledging the challenges the Committee will face in the coming months as it prepares to report to the Oireachtas, the Health Reform Alliance commended Committee members on their work to date and in recognising the need for Cross-Party action.