Analysis:The influence of the HSE and its new head was evident yesterday, writes Dr Muiris Houston, Medical Correspondent
The influence of the Health Service Executive (HSE), and in particular its new chief executive, Prof Brendan Drumm, can clearly be seen in the Health Estimates for 2006 announced yesterday.
The National Primary Care Strategy, having sat in the doldrums since its launch in 2001, is back to centre stage. With an additional €16 million promised for primary-care services next year, Minister for Health Mary Harney said the money would ensure maximum front-line impact.
She wants the HSE to appoint an additional 300 health professionals, to include social workers, physiotherapists and occupational therapists, to build up an additional 75-100 primary-care teams.
Central to the primary-care strategy, just 10 of these teams have been funded to date, leading to frustration among general practitioners. Now selected GP practices can look forward to the arrival of an average of four new members.
However, "bringing improved primary-care services to 600,000 people by the end of 2006", as promised by Ms Harney, may be somewhat ambitious in terms of timing.
Funding will also be provided to bring comprehensive GP out-of-hours services to some 70 per cent of the population. And increasing the number of GP-training places to 128 is a recognition of the manpower crisis facing primary care.
All of these initiatives bear the hallmark of Prof Drumm, who has consistently argued that the development of primary care and community services was the key long- term solution to the accident and emergency crisis.
Unlike last year's estimates, with the trumpeting of the 10-point A&E plan, the only direct reference to accident and emergency in yesterday's speech was to specify a €5 increase in A&E charges. And while last year's initiatives will continue to develop, it may well be that Ms Harney, too, is looking to longer-term answers to the perennial scourge of the health service.
Another major initiative this year is in the broad area of medical education. School-leavers are to be allowed direct entry to midwifery and paediatric nursing training, leading to an increase of 240 in the number of undergraduate nursing places available each year.
The Minister has also listened to Prof Patrick Fottrell and his expert group on medical training. Giving a clear commitment to the recommended doubling of medical student places, Ms Harney began the process by promising 70 new undergraduate places for next September.
With up to 1,000 additional hospital consultants and extra GPs needed in the health system, yesterday's commitment is welcome.
There were a number of additional funding promises made by Ms Harney concerning specific areas of health. An additional €10 million for antiviral drugs and vaccines for use against a possible avian flu outbreak is an essential strategic move.
Cancer services are to get an additional €9 million, which is likely to fund the development of a cervical cancer-screening programme as well as implementing the Hollywood radiotherapy plan.
Neurology services are to get an extra €3 million; a welcome addition to an area whose development has lagged behind in recent times. And specific initiatives to improve care of the elderly are to be announced in the budget.
With a definite swing towards primary care and an acknowledgment that we need to train a lot more health professionals in order to staff even existing initiatives, the Minister has changed emphasis in this year's budget estimates. It is now up to Prof Drumm and the HSE to implement these priorities.