This document discusses healthcare reform in Ireland, outlining both progress made and future plans. It establishes a vision for a single-tier universal healthcare system with equitable access based on need. The reform agenda includes developing primary care, chronic disease management, reducing waiting times, and structural reforms like establishing hospital groups. While timelines have been adjusted, ongoing work includes advancing primary care, implementing hospital groups and money following the patient, and further developing proposals for universal healthcare insurance.

1. Healthcare Reform:
What Next?
West/North West Hospital Group
Fergal Lynch
Deputy Secretary General
Department of Health
9 October, 2014

2. Context
 Health Reform is a major agenda item for
Government
 Change in timetables for some elements –
not a reversal of the reform programme
 Some progress made and much more to
be done
 Locate the debate on Hospital Groups in
the wider context of health reform

3. Vision for Future System
Single-tier system
Access based on need, not ability to pay
Universal coverage of primary and hospital
care (primary care free at point of use)
Best health outcomes for available resources
Treat patients at the lowest level of
complexity that is safe, timely, efficient and
as close to home as possible.

4. Vision Statement
To develop an efficient and effective
single-tier health service which
promotes equitable access to high
quality care on the basis of need.

5. Reform Agenda
 Future Health promises major reforms
 Health and Wellbeing
 Healthy Ireland to co-ordinate cross-cutting programme
across whole of Government
 Service reform
 Develop primary care as first point of contact
 Phased extension of free GP care to whole population
 Better programmes of chronic disease management
 Action on waiting lists and waiting times
 Licensing of healthcare facilities

6. Reform Agenda
 Future Health promises major reforms
 Structural reform
 New health structures
 Hospital groups, leading to independent hospital
trusts
 Purchaser/provider split and commissioning
 Financial and capacity reform
 UHI funding model based on competing insurers
 Single tier of access to replace ‘two-tier’ access
 Money Follows the Patient
 Reform PHI market
 Information

7. Where are we now?
 Healthy Ireland to advance the agenda on
Health and Wellbeing
 HSE Directorate structure
 Primary and Community Care structures
developed
 SDU and waiting times
 Hospital Groups policy
 Framework on Smaller Hospitals

8. Where are we now?
 Money Follows the Patient policy and
implementation process
 White Paper on UHI
 Transfer of HSE Vote
 Reforms in Private Health Insurance market
 eHealth Strategy
 Unique Identifiers legislation
 Health Information Bill
 Licensing legislation

9. Recent Developments
 Minister reviewed and adjusted timeframes
for implementation of UHI funding model
and health structures
 Substantial health reform projects (above)
to be advanced in the meantime
 More work to be done on the ‘what’ and
‘when’ of UHI
 Work continues on health structures – a
major piece of work on what ‘map’ of Irish
healthcare will look like

10. Next Steps
 Key priorities for next 18 months identified
 Health Statement of Strategy and HSE
Corporate Plan
 Costing of UHI and further examination of
the right approach for Ireland
 Vital to pursue agenda of structural
reform, including that of Hospital Groups
within it