Tag Archives: minister for health

1 year maximum on Hospital Waiting Lists

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Waiting Lists to be reduced

Waiting Lists to be reduced

All public hospitals are being instructed to ensure they have no patients waiting more than 12 months by the end of the year. The Minister for Health Dr James Reilly has also announced changes in the role of the National Treatment Purchase Fund (NTPF), which will take place with immediate effect (Irish Medical Times)

 

These changes are another stage in the implementation of the Government’s health reform agenda and follow on from the establishment of the Special Delivery Unit, the Minister said.

Besides the waiting list instruction, there are two other main three changes involved. The NTPF will target particular backlogs rather than routinely accept referrals of patients waiting over three months. The requirement that the NTPF purchase 90 per cent of treatments in the private sector is being ended.

“When I announced the setting up of the SDU, I said that the role of the NTPF would be changed to support the mission of the new Unit. The SDU led by Dr Martin Connor is already putting systems in place to track, monitor and manage patient flows through the hospital system.  I intend that the resources of the NTPF, and by that I mean not just financial resources but also its data systems and highly-trained and experienced staff, will now be fully aligned with the SDU,” the Minister said.

The NTPF is entering a transition phase. It will continue to fund patient treatments but will be shifting its focus to target waiting lists more strategically, to deliver more treatments for the funds provided and to incentivise hospitals to manage their lists proactively in the interests of patients.

The SDU is carrying out a detailed analysis of the management of elective and non-elective care. However, it is already clear that individual hospitals can do more to reduce maximum waiting times for their patients.

“It is  unacceptable that hospitals leave some patients on waiting lists for very long periods of time, safe in the knowledge that the NTPF will eventually pick up the tab. I will no longer tolerate this attitude to patients – hospitals need to become accountable for the listing decisions of their surgeons. As part of the changes I am announcing today, I am requiring all hospitals to ensure that they have no patient listed as waiting over 12 months for treatment by the end of the year. Where they fail to do so, the NTPF will source the necessary treatments and the hospitals’ budgets will be reduced by a corresponding amount in 2012,” the Minister said.

“I want a system where the patient and taxpayer get the greatest return on scarce resources consistent with quality and safety. The NTPF will purchase treatments wherever it gets the best value in either the public or the private sector. I want the NTPF to drive a hard bargain on behalf of patients without regard to the location of the treatment,” the Minister said.

The SDU will be introducing a more focused strategy to target treatments for patients. This will require new data systems, a new accountability framework and a sustained focus by clinical and management leaders in hospitals to reduce the lists from their present level and prevent them building up again. As part of these changes, the Minister has decided that for the remainder of this year, the NTPF will no longer routinely accept referrals for those patients waiting over three months, as at present. It will still provide treatments for patients but will target specific backlogs.

Follow-up treatments for existing patients will be provided, as is the normal practice.

The NTPF and the SDU are already working in close collaboration, the Minister said. The NTPF capability will be a core part of the SDU’s performance management role in holding public hospitals to account. The changes being announced today lay the foundation for this transformation and introduce the concept of rigorously-enforced maximum waiting times.

These maximum waits will be systematically reduced in the coming months and years to “deliver the goal of eliminating excessive waiting lists from the Ireland health economy,” the Minister said.

Welcome to our new Health Minister – Dr James Reilly

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Dr James Reilly

Dr James Reilly

As was widely expected, Fine Gael’s Dr James Reilly has been appointed Minister for Health in the new coalition Government (Irishhealth.com)

Dr Reilly was first elected to the Dail in 2007 and was appointed Fine Gael health spokesman shortly afterwards. He was appointed the party’s Deputy Leader last July.

He faces a challenging task in pushing through the major health reforms promised by the new Government, most importantly the introduction of a new universal health insurance (UHI) system which aims to end  two-tier care and give everyone equal access to GP and hospital treatment based solely on medical need.

The Government has promised free GP care will be introduced within its five-year term of office, following which the UHI system will come in, allowing for universal hospital care.

Dr Reilly also faces the more immediate task of dealing with waiting lists, bed capacity and emergency department overcrowding. The new Government has promised to set up a special delivery unit aimed at eliminating long patient waiting times.

The new Minister comes from a medical family going back three generations. His father, Dr Noel Reilly, was Secretary General of the Irish Medical Association. There are seven doctors in his family.

A GP in north Dublin for many years and a fourth generation native of Lusk, James Reilly is married with five children.

Prior to entering national politics, he had a major involvement in medical politics, having served as President of the Irish Medical Organisation (IMO) and Chairman of the IMO’s GP Committee.

He led the IMO negotiating team which negotiated a lucrative deal for GPs following the extension of the medical card scheme to all over 70s regardless of income in 2001.

Dr Reilly has, however said that the will not shirk from taking on vested interests in implementing reforms. He has already promised to negotiate new contracts for GPs and consultants and cut their earnings.

It’s goodbye to our Health Minister

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Mary Harney out

Mary Harney out

According to IrishHealth.com, Mary Harney has brought to an end nearly six-and-a half-years as Health Minister with the announcement of her resignation from the Cabinet.

She offered her resignation to the Taoiseach, which has been accepted, and has announced she will not be standing in the forthcoming general election. It had been speculated for some time that she would not run in the election.

Ms Harney said she offered her resignation to Brian Cowen last week but was told to hold off on making the announcement.

Mary Harney was appointed Health Minister in September 2004. She was previously Minister for Enterprise Trade and Employment.

A former Tanaiste, Mary Harney has witnessed the demise of the party she helped found – The Progressive Democrats- while serving as Health Minister.

She is the second longest holder of the health portfolio in the history of the State, but her critics will say that after more than six years, she should have achieved more.

While she has had some limited successes as Minister – the Fair Deal nursing home funding scheme; providing for better regulation of doctors and other health professionals; reducing drug costs to some extent and bringing in doctor visit medical cards, on the big healthcare issues she has essentially failed to deliver.

Early on in her ministry she promised to resolve the ongoing A&E crisis. Years later, emergency department trolley numbers have reached record levels and the Minister continued to offer little in the way of concrete solutions to the ongoing hospital capacity crisis.

The Minister told the Dail last week: “we must become less focused on beds and more focused on activity.”

Despite her exhortation, the rest of the country was extremely focused on beds, and the lack of them. Patients were becoming less focused on beds as more and more of them got used to waiting on trolleys.

As Minister, Mary Harney presided over considerable bed reductions, which took place long before an alternative system aimed at reducing reliance on hospital beds was put in place.

Mary Harney’s plan to increase capacity in the system by decanting private beds from public hospitals into co-located private units failed. Nearly six years after she announced co-location as a quick solution to hospital capacity problems, not one co-located hospital or bed has opened.

The cancer services reorganisation is regarded as a success on Ms Harney’s watch, but much of this success was down to Prof Tom Keane. In any case, the report proposing cancer service reorganisation had lain on a shelf for years and was only activated after a number of breast cancer misdiagnosis scandals emerged during the Harney era.

Other more negative aspects of Ms Harney’s Ministry that will be rembered include:

* Failure to reform the HSE, a structure she effectively inherited from her predecessor, Micheal Martin, but whose establishment was very much in line with her reform-minded PD policy.

* Early in her ministry, the fall-out from the scandal over illegal overcharging by health authorities of public nursing home patients for many years.

* The attempt to take medical cards off thousands of over 70s.

*Frequent expressions of regret over the latest hospital care or misdiagnosis scandal and claims that hospital safety would improve despite her efforts , Mary Harney failed to convince the public that she was making healthcare provision safer.

* ‘Taxing the poor’, by introducing prescription charges. Ireland must be one of the few developed countries where those on the very lowest incomes are charged for treatment,albeit at a low rate.

* Her recent clash with Ombudsman Emily O’Reilly, with the Minister insisting that the State was not legally obliged to provide public long-stay care for the elderly.

*Her failure to effectively tackle waiting list numbers, despite the NTPF, and in particular waiting times for outpatient appointments.

*Controversy over her expenditure on business trips abroad as Health Minsiter and in her previous ministry, not to mention her lengthy stay in New Zealand as the Tallaght x-ray crisis unfolded.

So is it goodbye and good riddance or just farewell?

St Lukes Next?

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The next Victim of the Health Bill 2010 ?

The next Victim of the Health Bill 2010 ?

Is St Lukes next on the chopping board for Mary Harney? It seems this is where she has her eye.

It has been reported that the cancer facility will be kept on as a terminally ill care centre as opposed to being “sold off”. Operations will be split between St James’ and Beamont Hospitals, with a portion of staff transferring to St James’ and Beaumont at the latter end of this year. The remainder of staff will be transferred by 2014.

Health Minister Mary Harney was bringing the Health Bill 2010 to the Oireachtas Committe on Health and Children, which allows for the detachment of the hospital boards and the transfer of assets. The plans for closure will continue with the reorganisation of cancer services in eight hospitals.

Radiotherapy will be transferred to Beaumont and St James’.

“The ethos of St Lukes is to keep it as a hospital and not have it sold”, said Harney. “Land near the city centre for public health use is hard to find and there is a growing demand for health services.”

Although this has been justified by the Health Minister, it has not been met with as much support as first imagined. It has caused immeasurable controversy and hurt to those who have survived cancer and who have been at the mercy of the fantastic staff at St Lukes.

Chairperson of “Save St Luke’s Hospital” campaign and cancer survivor Joe Guilfoyle says ” St Lukes is one of the few success stories of our public health system”.

Guilfoyle goes on to add “Its is a hospital that patients like me are very happy to travel to. It is unacceptable that the minister is attempting to close it”.

I myself look forward to hearing more on what could potentially be damaging news to those who St Lukes have been paramount to their recovery.

Has the Health Minister gone too far this time or is this all part of a grand scheme of events to help the Irish public health system?

We’ll see.