New regional bodies will in future administer both hospital and community services in an integrated manner with a single budget under a single board, the Minister for Health Simon Harris has said.
The Minister said he wanted to move ahead with aligning the geographic areas covered by existing hospital groups and community healthcare organisations.
He said there would be one budget and one board for each regional entity to hold people to account. He said this would help to deliver integrated care.
The Minister said he would produce proposals on how the country could be divided up as part of the new geographic alignment of hospital groups and community healthcare organisation in the months ahead. He said he would need cross-party support in legislating for this initiative.
“Drawing lines on maps is never the easiest thing for any politician to do”, he said.
Mr Harris told the Oireachtas health committee on Wednesday that this initiative was "the potential game changer" in the delivery of the Sláintecare reform programme.
Silo approach
The Minster said he was keen to move away from the silo approach with duplicate management structures for hospitals and community care services.
“If we are to deliver Sláintecare we need a singular budget for certain parts of the country to deliver the whole spectrum of care.”
He said there would no longer be “silo budgets” for hospitals and community care services. He said there would no longer be arguments that patients had to remain in hospitals because it would cost money from someone else’s budget to care for them in the community and vice versa.
The Minister said the existing HSE structure was “not fit for purpose”.
He said there would always be a need for some issues to be addressed at national level such as the overall maternity strategy or cancer strategy.
However he said the existing “core” HSE was “too big and too bloated”.
Mr Harris also said about 600 additional hospital beds will be provided in the next three years through a combination of modular buildings and the reconfiguration of existing space. He said "a fair chunk" of these would come in the latter part of 2019 including a 60-bed modular unit at Limerick University Hospital.
The Minister told the committee he backed the proposals in the Sláintecare reform report to end the treatment of private patients in public hospitals. However he said this would have to be carried out in an intelligent and phased way.
He said the current system was an “outlier and fundamentally unfair”.
Mr Harris said this could see a public hospital at full capacity in which a patient in greater need of care had to wait for that care because someone was carrying out private practice.
“We cannot convince ourselves that this is the norm”, he said.
Agreement
He said a report to provide “valuable guidance on how we go about implementing the recommendation (to eliminate private practice in public hospitals) would be completed by the end of the year or early next year.
Mr Harris also said he had reached agreement in recent days with the Minister for Public Expenditure on a substantial multi-annual budget for the provision of GP services . He said he hoped intensive negotiations with GPs on a new contract – which have been stalled for months – would get underway again very shortly.
The Minister said he envisaged the talks would be like a three-leg stool. He said one part would focus on measures to make existing practices sustainable; the second element would deal with the provision of chronic disease management in general practice and the third would address the provision of greater access to primary care.
He said on foot of his agreement with the Department of Public Expenditure the policy objectives of his department had been aligned with the available funding stream.
