10-year Sláintecare plan: Government consider legal maximum wait time for patients

10-year Sláintecare plan: Government consider legal maximum wait time for patients
Pic: Gareth Chaney Collins

Update 6.40pm: The government is considering making it a legal requirement for patients waiting on an operation to be seen within a certain amount of time.

It comes as figures show almost one million people are waiting on procedures around the country.

More detail on the Sláintecare plan was launched this morning, though no costs have yet been revealed by the government.

Health Minister Simon Harris says they are examining how a legal maximum waiting time could be introduced: "We're going to next year in the plan we are publishing today develop policy on waiting list guarantees.

"If you're an Irish person waiting on a hip operation, a knee operation, a cataract operation, how long should you wait? How long can we guarantee that can be delivered? And then we're going to try and look underpinning that in legislation."

Social Democrats TD Roisin Shortall says that introducing legal maximum waiting times has worked in other countries.

"This was done in Scotland and it was done very successfully," said Deputy Shortall.

"Once the legislation is there and there is a legal requirement on clinicians and hospital managers to deliver on that and on the minister for health to deliver the funding necessary, then it will have to be done.

"It can take years to bring down waiting lists but if you have it set down in legislation well then action needs to be taken and it was proven in Scotland."

Earlier: GPs 'seriously disappointed' over implementation strategy

The Minister for Health Simon Harris launched the new Sláintecare Implementation Plan today saying it will be a guideline for the future of the health service.

The National Association of General Practitioners (NAGP) has said that today's response to the Sláintecare report "smacks of empty rhetoric".

Minister for Health Simon Harris TD Laura Magahy, Executive Director of the Slaintecare Programme Office. Pic: Gareth Chaney Collins
Minister for Health Simon Harris TD Laura Magahy, Executive Director of the Slaintecare Programme Office. Pic: Gareth Chaney Collins

It said that it is seriously disappointed over the absence of costings for the initial 106 actions which include a new GP contract.

The NAGP has stated that there has been no meaningful engagement since last November with the HSE, the Minister for Health or his Department on a new GP contract.

Chris Goodey CEO of the NAGP said: "If contract negotiations are further stalled the NAGP will have no alternative but to advise it’s members to work to contract.

GPs will be advised to precisely follow the terms of their outdated contract, and to follow all safety regulations. They will be advised to stop working lengthy unsafe hours and in particularly to stop any/all unresourced services.

The NAGP currently recommends that GPs who feel their practices have reached the limit of safe capacity, in terms of patient numbers, should close their lists to new patients.

Fianna Fáil spokesperson on Primary Care, John Brassil TD, has said that the Government's reaction to the 2017 Sláintecare report has "no real sense of urgency".

"In the fifteen months since we published the report, the ‘winter crisis’ in our Emergency Departments has extended into spring and summer," said Deputy Brassil.

"The Implementation Strategy is being published on a day when our nurses are reporting 520 patients on trolleys – a total that is unprecedented for August."

He went on to say that the plan promises "further reviews, frameworks and proposals over the next two years.

"In effect the Government is telling us that it doesn't yet know how to actually implement Sláintecare or how much it will cost.

"In its response it is clear that the Government is now matching its lack of urgency with a lack of detail."

Following today's launch, the Irish Nurses and Midwives Organisation (INMO) has said that it wants to see a focus on resolving the recruitment and retention problems facing the nursing and midwifery industry.

INMO General Secretary Phil Ní Sheaghdha said that more information is needed and said the INMO is awaiting an early meeting with Minister Harris.

“But the real challenge for Sláintecare is funding. There are already hundreds of nursing and midwifery vacancies across the country, which the HSE simply can’t fill," said Ms Ní Sheaghdha.

"Unless the government focuses on solving the recruitment and retention crisis in nursing and midwifery, the expanded services in Sláintecare simply won’t become a reality.

Nurses’ and midwives’ inadequate pay has to be addressed. And while ministers are right to allocate extra capital spending for the health service, that will be money down the drain unless new facilities are properly staffed.

The Health Reform Alliance welcomed the publication of the strategy saying it was "an important step on the road to universal healthcare in Ireland".

However, it also highlighted the absence of costings in today's strategy and called for a commitment for multi-annual funding to be made from Budget 2019 on.

Paul Gordon, Co-Chair of the Health Reform Alliance said: "While we note that a further action plan is to be published by the Sláintecare Executive Director by year end, there is a real danger that progress could be stymied by disagreement with the Department of Public Expenditure and Reform during the Budget estimates process."

Kathryn Reilly, Co-Chair of the Health Reform Alliance said: "The Implementation Strategy commits to the establishment of a transition fund in the 2018/2019 period, yet it is unclear if discussions with the relevant Government Departments have taken place yet in the context of the estimates process.

"The transitional fund is critical in the implementation of Sláintecare and its inclusion in the strategy is a strong signal of Minister Harris’ intent.

"However, the fund must be resourced in line with the Sláintecare report."

Earlier: Government to spend €1bn on E-health and deliver 2,600 extra beds

The Minister for Health Simon Harris has defended the government's record after figures released this morning by Fianna Fáil show that almost 1 million people are on hospital waiting lists.

Mr Harris launched the new Sláintecare Implementation Plan today saying it will be a guideline for the future of the health service.

10-year Sláintecare plan: Government consider legal maximum wait time for patients

It includes commitments to reduce hospital waiting times, increase bed capacity and to try to disconnect public and private healthcare.

Speaking on Today with Miriam on RTÉ Radio 1 this morning, Mr Harris said there are far too many people on waiting lists, who are waiting for far too long.

"We didn't wake up to a million people on waiting lists this morning, we woke up to Fianna Fail taking out a calculator and adding up figures...most of which were in the public domain coincidentally on a day we are launching a major strategy and look, that's politics," he said.

He said he didn't disagree that there were far too many people waiting but he was much more interested in what the Government were going to do to fix it.

"We cannot have a situation where the Minister of Health of the day, whoever he or she is, is constantly just dealing with a daily crisis, we have to have a ten-year plan to reform the health service," he said.

He said the Government would be spending €1bn on E-health and that they would be delivering 2,600 extra hospital beds and that staffing for those beds is "vital".

Mr Harris also said that €800m more would be spent on putting diagnostic equipment into the community so that people did not need to go to hospital for an x-ray.

"This is a radical plan to deliver universal healthcare," he said.

He said if the Government moved to take private patients out of public hospitals it will require a new consultants contract.

"What we do here in Ireland is abnormal, it is not normal to have a crowded emergency department in a public hospital and have beds up the house being occupied by patients with private health insurance," Mr Harris said of the current system.

You can listen to the full interview here:

Sláintecare

The Sláintecare Implementation Strategy published today "sets out a vision for the future of healthcare over a ten-year period".

According to Mr Harris, the strategy "provides the framework within which a system-wide reform programme will be advanced".

"At its core, the strategy focuses on establishing the building blocks for a significant shift in the way in which health services are delivered in Ireland," he said.

10-year Sláintecare plan: Government consider legal maximum wait time for patients

Taoiseach Leo Varadkar said: “We know that our health and social care services as currently designed cannot meet the growing demands being placed on them.

"Our population is changing rapidly, bringing with it changing healthcare needs. There is an overwhelming consensus that a transformation is needed in the way we deliver care and that this must be planned, managed and delivered within a coherent system-wide reform programme.”

    The key actions for the first three years of reform include:
  • Establish HSE Board and reconfigure the HSE to improve accountability and support integrated care
  • Deliver a new Model of Healthcare through the development of a new Citizen Care Masterplan for the health service and new models of care that are population-health centred
  • Launch a programme of public engagement on Health Outcomes and a nationwide series of events in 2019/2020 to promote health and well-being
  • Enhance Community Care, including the expansion of community-based diagnostics facilities, a new community nursing service and a continued programme of investment in primary care centres
  • Reform the GP contract, including providing for a greater role in chronic disease management
  • Continue investment in community mental health services
  • Introduce a new statutory scheme for homecare services
  • Review the eligibility framework to develop a roadmap to achieve universal entitlement
  • Increase bed capacity in public hospitals
  • Choose locations and commence the planning process for new elective hospitals in Cork, Dublin and Galway
  • Tackle long waiting times for acute hospitals by continued investment in the NTPF and the development of an integrated waiting list management system
  • Develop a national clinical strategy and hospital group strategic plans to guide organisation of hospital services
  • Roll out eHealth systems and infrastructure


The Sláintecare Implementation Strategy is available at www.gov.ie/Sláintecare

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