The centre of the Government’s health reform programme is the creation of a single-tier health service, which is supported by a scheme of Universal Health Insurance (UHI). The Government set out the framework for delivering these reforms in its document “Future Health: A Strategic Framework for Reform of the Health Service 2012-2016”
, which was published in November 2012. Future Health
represents the single most fundamental reform of the health services in the history of the State. It sets out the main building blocks to achieve these reforms which are aimed at restructuring how health services are delivered across primary, community and hospital sectors.
The challenge of ensuring that these reforms are implemented successfully and on target is immense, specifically when considering the need to reduce costs and at the same time deal with increased demands for public services. The financial pressures on the health system make it even more important that comprehensive health reform is introduced. Only in this way can the services people need be delivered, even as the available financial resources diminish. The Health Reform Plan however is fundamentally changing the health service for the better.
One of the key reforms is the development of eHealth
, which is about the transfer of health resources and health care by electronic means, including health information, education and training and health management. The use of eHealth will result in greater efficiencies, savings and improved patient care through faster and better diagnosis.
The Future Health
programme is built on four key interdependent pillars of reform:[i] Health and wellbeing:
to keep the population healthy rather than just simply treating ill people; [ii] Service reform:
to deliver a new, less hospital focused model of care, which treats patients safely, at the right time, with value for money, with the right service and as close to home as possible. An example of this is how the HSE is working with organisations such as the Genio Trust
, a registered charity, to develop new ways of providing services to people in the community, such as people with dementia. It is proposed to expand these projects to include hospitals. The lessons learned will be applied more broadly to the development of health services.
The priority objective is to enable people to age with confidence, security and dignity in their own homes and communities for as long as possible. The Department of Health is currently reviewing the Fair Deal scheme with a view to removing barriers to patients and providing more financial support for home care so that more patients can be maintained in their homes and communities. The Positive Ageing Strategy
will support people in maintaining their physical health and wellbeing;[iii] Structural reform:
to implement the steps, including the necessary legal and structural changes to the health system, that will be required to fundamentally shift the model of public health care from a tax-funded system to combination of UHI and tax funding; and[iv] Financial reform:
to ensure that the financing system is based on incentives that are aligned to fairness and efficiency, while reducing costs, improving control and delivering better quality.