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Working together to implement Sláintecare and improve the health service

I am once again very happy to contribute to the Medical Independent’s IHCA Annual Conference Preview.

I was delighted to be in a position to submit the Sláintecare Implementation Strategy to Government in July and to have received significant support from my colleagues. The Government is committed to achieving the transformation set out in the Strategy and it will require investment, strengthened governance and accountability and a coherent programme of reform.

The Implementation Strategy, which I published on 8 August, is a further step in the detailed implementation process and sets out four over-arching goals and 10 high-level strategic actions, which will be the key focus for the first three years of the reform programme. The Strategy focuses on establishing the building blocks for a significant shift in the way in which health services are delivered in Ireland. A Sláintecare Programme Office in my Department, led by an experienced Executive Director, is currently preparing a detailed action plan, which will be published before the end of the year. 

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Mr Simon Harris

I have always been clear that we must match reform with investment, and with an increase in capacity. The Health Service Capacity Review (2018) recommended an increase of 2,600 acute hospital beds and 4,500 additional long- and short-term community beds.  The Government’s National Development Plan 2018–2027 commits that €10.9 billion will be invested in health infrastructure and reform. This will support the Sláintecare reform programme; increased capacity, including the provision of three elective-only hospitals in Dublin, Galway and Cork; and additional facilities will also be provided for primary care, mental health services and disability services.

I have also obtained Government approval for the establishment of an independent Board for the HSE. The General Scheme of a Bill has been published and I hope that legislation will be enacted this year. I have already announced that Mr Ciarán Devane is my designated Chairperson for the new Board. Early tasks for the new Chair will be to participate in the selection of the CEO of the HSE, the process for which is underway and to participate in the process for identifying other Board members. This is another important step in the implementation of a key Sláintecare recommendation.

I believe it is unfair that private patients can access treatment more quickly than public patients. I understand, however, that removing private practice from public hospitals is a complex process and the consequences of doing so must be analysed and carefully considered. I expect to receive the report of the group established to examine the impact later this year.

The Public Service Pay Commission in its report, published last month, covering medical staffing, highlighted the recruitment and retention of highly-skilled, well-trained and appropriately qualified healthcare professionals in the public health service as a dominant imperative. In order to deliver high-quality care across the health services, the Government and I recognise that the recruitment and retention of highly-trained and skilled medical staff is essential.

I see the settlement agreement reached in June as an important step towards ensuring that we retain our established consultant cohort and I am pleased that most consultants have responded positively to the Agreement. New-entrant consultants are encompassed by the process announced for new entrants across the public service under Section 4 of the Public Service Stability Agreement. However, the Commission had noted the degree of pay differential that is likely to apply following the settlement agreement notwithstanding this process and proposed that the parties to the Public Service Stability Agreement jointly consider what further measures could be taken, over time, to address this difficulty. The challenge will be doing so in a manner that respects pay policy and our budgetary constraints.

The Commission also highlighted the need to ensure that the overall employment, professional development package, working conditions and culture available in Ireland be sufficient to attract the right people when and where they are needed. I recognise this as an equally significant challenge and one that must be met. The Medical Council has reported on the need to facilitate the training of not just junior hospital doctors, but also consultant trainers. It is evident that the current difficulties in ensuring protected time for junior doctors and consultants is indicative of the current level of demand for services and related work pressures. I believe that the Government’s commitment to increasing capacity across our health services and the full implementation of Sláintecare can have a significant positive impact on improving the working conditions of all of our medical staff.

Reform is challenging and requires leaders and champions throughout the system. As senior clinicians, members of the IHCA have a key role to play in providing this leadership. I am confident that they will play their part in transforming Irish healthcare and help to build a system that is both fit for purpose and a great place in which to work. One of the strategic actions in the Sláintecare Implementation Strategy is to build a sustainable, resilient workforce that is supported and enabled to deliver the Sláintecare vision. I look forward to working constructively with consultants and the IHCA to deliver this.

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