As chairman of the Oireachtas Committee on Future Healthcare, it fell to Independent Clare TD, Dr Michael Harty, to present Sláintecare, an ambitious new healthcare plan for Ireland.
Dr Harty explains: “This is the first comprehensive plan to reform our health service that has emerged in modern times. It is designed to deliver a modern health service that is safe, fair and just. Sláintecare is a once in a generation opportunity to fix our broken health system and I respectfully ask all stakeholders to hasten slowly in considering the report and avoid a knee jerk reaction.
This visionary report contains the best options for reform that will transform our health system over 10 years. We have no choice, the Government needs to get behind this report and the new Taoiseach and the Minister for Health must examine its recommendations and adopt its implementation programme which will drive this report forward within the next 6 months.
We have a healthcare system that is centred on the hospital. Sláintecare sees an urgent need to re-orientate the system so that the vast majority of care takes place in primary and social care settings. Of course it will not be cheap and this new model will require a significant and ongoing investment in the region of €2.8bn over a ten year period.
The shift away from hospitals will require additional measures for infrastructure and training, so a transitional fund of €3bm will be required to support investment. I fully acknowledge the taxpayer will need convincing that such an investment will end waiting times, trollies in emergency departments, inadequate home care, unacceptably long waiting times for appointments, GP shortages and the many other failings in our services.
Change will only come about if Government, with the support of the Dáil, insists on a new order. New governance structures underpinned by legislation will be required to guarantee entitlement to care. The report proposes a Cárta Sláinte which will entitle all residents to access a comprehensive range of services based on need. Such access includes expansion of entitlements to provide universal primary care to the entire community. This access will be legislated for, and implemented over a 10 year timeframe.
Integrated primary and secondary care system have to be underpinned by legislation leading to a more efficient and cost effective service. One of the most controversial proposals is the disentanglement of private care from public hospitals. People may still opt for private health insurance to cover treatment in private hospitals and the report does not propose any change in tax relief for health insurance.
Every citizen will be entitled to treatment in public hospitals but health insurance will not confer any extra benefit in a public hospital. The provision of private care in public hospital is an obstacle to reform which must be recognised and addressed. Indeed the report expects to see a marked decline in private health insurance as the quality of the public system improves under the plan’s proposals. Irish people, by and large, do not buy health insurance by choice, but believe they have to because of an inadequate public system.
Phasing and sequencing has to be done properly. We must not destabilise the existing system so that it becomes worse. Undoubtedly, some aspects of this plan will raise eyebrows in the medical profession. There will be a lot of change for the all health professionals which will have positive benefits in improving working conditions, job satisfaction, career progression and will make the Irish health service a place where one wants to work and have a fulfilling career.
I would say to consultants and doctors that they need to read the entire document and not just the area that is of particular interest to them because the plan is fundamentally about the patient. Sláintecare is a holistic solution for dysfunctional health service.”