Strategic Framework for Reform of the Health Service

1. Strategic Framework for Reform of
the Health Service
Dr Ambrose Mc Loughlin
Secretary General
Department of Health
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2. Context of change
Driving the changes with a major cost reduction agenda
and higher demands for public services
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3. The Vision
a single tier health
system, supported by universal
health insurance, where access
is based on need, not income
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4. There is a Plan
Health and Well Financial reform
Service Reform Structural Reform
Being
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5. Principles of
Reformed System
Keeping People
Equity Quality
Healthy
Regulation and Patient-
Empowerment
Patient Safety centredness
Efficiency and
Effectiveness
Dr. Ambrose Mc Loughlin, Secretary
5
General, department of Health

6. The Time Frame
Q1 2013 Q3 2013
UHI: UHI:
 Preliminary paper ppublished in February.  Policy appraisal of UHI Models will be completed.
 UHI Design Team to be established
Money Follows the Patient: Money Follows The Patient:
 Policy paper published in Febuary & stakeholder consultation
 Policy proposals will be developed for introduction
process commenced.
 HSE Project Manager and HSE National Leads for Pricing,
of case based charges for private patients in
Commissioning and Hospital Support will be assigned and MFTP public hospitals.
Oversight Group will be established
 External State of Readiness Report for roll-out of MFTP will be Review of HSE Integrated Service Areas:
completed  Review to be completed to (i) ensure maximum
Permanent Scheme of Risk Equalisation: alignment between all service providers at local
 In place in January. level (ii) review executive management and
government arrangements and (iii) inform new
Hospitals: structures for the delivery of Primary Care.
 Report on Hospital Groups and Smaller Hospitals Framework will
be submitted to Government shortly.
Q2 2013 Q4 2013
UHI: UHI:
 Paper on Macro Level Funding Flows will completed.  Policy papers will be completed on (i) Basket of Services
 Legal Appraisal of UHI Models will be completed. and (ii) Funding & Financial Support Services.
Money Follows The Patient:
Money Follows The Patient:
 Detailed Implementation Plans progressed for ‘go live’ from
 National Casemix Conference to be held in April as key 2014.
element of stakeholder consultation.
 Shadow Based Budgeting to commence. VHI:
 Regulatory status of the VHI will be addressed in line with
Extension of Free GP Care to Persons with Prescribed ECJ ruling.
Illnesses:
 Bill to be published. Health Information Bill:
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 Preparation work completed to allow publication of Bill.

7. The Process
Programme Systems
Management Reform
Office Function
Programme
• Department of
• HSE
Board Health
Programme Management & Collaboration
Strengthens Capacity to Move Swiftly
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8. Patients First
Healthy Ireland
A Framework for
Improved
Health and Wellbeing
Patient
Safety
A Whole of Government Approach
26/03/2013
Agency 8

9. The Plan is Working
• This year to date 14.7% less patients waiting on trolleys compared to 2012
• No of adults waiting more than 9 mths for inpatient and day case surgery was
down to 86 at end of December 2012
• No of children waiting over 20 weeks was down to 89 at end of December
2012
• No of patients waiting over 13 weeks for routine GI endoscopy was down to
36 at end of December 2012
• THIS IS REAL PROGRESS
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10. Building the Foundation
Legislative Reform
Health Service (Executive) Governance Bill 2012
The Health (Pricing and Supply of Medical Goods) Bill 2012
Health Amendment Bill (No 3) Return of vote to Department of Health
Legislative Reform
Policy Papers
Money Follows the Patient Policy Paper Published 15 February 2013
The Path to Universal Healthcare Published 15 February 2013
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11. We can Show Results
Structural Reform
The Establishment of Hospital Groups as a Transition to Hospital Trusts Groups
Securing the Future- Framework for Smaller Hospitals
HSE Directorate Structure underway
ISA Review about to commence
Financial Reform
The roll-out of a comprehensive financial management system is a priority for
the Department and the HSE in 2013.
Shadow Funding will commence in 2013 with go-live in 2014
New Risk Equalisation Scheme approved by European Commission
Dr. Ambrose Mc Loughlin, Secretary
26/03/2013 11
General, department of Health

12. Real Reform
Reforming Primary Care
• Introduction of a new contract for GP’s emphasis on chronic disease
management
• Bill to allow for extension of free GP care to persons with prescribed
illness due to be published later this year.
• €20 million available to recruit front line primary care teams (250
posts)
• Major capital plan to be announced by Minister shortly. Will provide
for 43 Primary Care Centres by various means.
• New Paediatric Hospital underway
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13. Real Reform
Reforming Social & Continuing Care
• A National Implementation Framework for the Value for Money Review of
Disability Services Published in February 2013 and Oversight Board
established
• € 70m allocation to strengthen community based mental health services
• National Positive Ageing Strategy to be published shortly
• Single Assessment Tool for Older People in development
• Review of Nursing Home Support Scheme to start shortly
• Review of the status of Public Nursing Homes by HSE complete and will form
the basis of future proposals to maximise the number of units retained
within existing resources
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14. Outcomes for All
Faster
Fairer
Access to
Hospitals
Free Access to GP
Affordability
Care
Improved
Health and
Well being
Better
Improved
Management
Quality
of Chronic
and Safety
More Illness
People
Cared for
in their
Homes
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15. Conclusion
Most comprehensive reform since
foundation of State
Good progress to date the reforms
are working
We need to build on our success
Dr. Ambrose Mc Loughlin, Secretary
26/03/2013 15
General, Department of Health