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Up for the challenge

Since becoming Minister for Health and especially as I have been travelling around the country visiting hospitals and local healthcare facilities, I’ve been struck more and more by the incredible work that people in our health service do every day and the many positive things that are happening.  I was very glad to see this showcased so well in RTÉ’s documentary series ‘Keeping Ireland Alive: The Health Service in a Day,’ which so clearly brings home the incredible work done by staff working in the health service every day. But this is not to understate or avoid the many challenges we face in the longer term.

It was clear to me from the start, as I engaged with people across the health service, that there was no lack of appetite for reform but there was a sense of fatigue at piecemeal reform and direction changes with every new Minister.  The message was loud and clear: We need a reform agenda and a long-term vision but we need one that doesn’t change when the Government does.

That’s why I think the establishment of the cross-party Committee on the Future of Healthcare was so very important and why I am delighted that last Wednesday (14 September) the special Committee began its public hearings on devising that long-term strategy. Prior to that the Committee invited and received a substantial number of high quality submissions, which will be reviewed by the members and inform policy development. I know the input of the IHCA to this process will be important.

Realistic goals

In the shorter term, I have been focusing on some realistic, achievable goals to make improvements to services this year.  Chief among these was putting the health service on a sustainable financial footing for 2016 with the delivery of a revised estimate of €500 million. This also allowed me to fund new or Programme for Government initiatives including a €40 million investment in home care services, €31 million for people with disabilities, the restoration of the ring-fenced mental health budget, and the recently-launched Winter Initiative to help address overcrowding in emergency departments (EDs). I have also been able to launch a waiting list action plan for this year, ahead of the Programme for Government commitment to €50 million in funding for this in 2017, and commissioned the NTPF 2016 Endoscopy Initiative, which will assist in reducing the waiting lists and waiting times for endoscopy procedures for those patients who are currently waiting over 12 months.

It is true that hospital activity has again increased significantly this year and the demand for acute hospital services continues to place significant pressures on our hospitals.  Within the Winter Initiative, measures are planned to increase hospital capacity, reduce ED overcrowding, and increase the availability of community care, which will facilitate timely discharge from hospital. Despite significant year-on-year increases in ED attendances, the number of patients on trolleys has reduced compared with 2015. However, there is no denial about the challenges of our ED overcrowding, the impact it has on the comfort, dignity and safety of our patients, and the significant pressure it puts on our staff. I will be working as hard as I can to improve this situation but it also requires ongoing consultant intervention and support. 

Recruitment and retention 

The recruitment and retention of medical staff is a priority for all concerned with the current and future functioning of the Irish health service. For that reason it is important that the recommendations contained in the MacCraith Report are implemented in as short a timeframe as possible. Consultant support for the implementation of many of the recommendations is pivotal, particularly around mentoring and improving the working and training experience of doctors more generally. 

The number of consultants has increased significantly since 2007. The number of consultants employed by the HSE at the end of July 2016 was 2,786. This constitutes an increase of 3.7 per cent over the July 2015 figure and an increase of almost 600 on the June 2007 figures of 2,189. This is reflective of the Government’s commitment to increasing consultant numbers and I recognise consultant recruitment must continue to be prioritised. Implementation of the Consultant Recruitment Group Report, recently approved by the HSE Leadership Team, will result in a more structured and co-ordinated consultant appointment system, with significant benefits for consultants taking up posts and patients requiring consultant care. 

I recognise the really pivotal role consultants play in the planning and delivery of care and I look forward to engaging constructively with you to achieve the best outcomes for patients.

As a member and a Minister in the 32nd Dáil, the new parliamentary landscape has many unfamiliar features, but is a regular, positive reminder that diversity need not mean division and progress can be made through constructive engagement and building consensus. I am sure that by working together – consultants, nurses, doctors, patients, and society as a whole – we can achieve a 10-year vision for a world-class health service, while continuing to deliver improvements for patients along the way. I am up for that challenge, I have no doubt the IHCA is too and I look forward to hearing the contributions at the forthcoming AGM.

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