Policy Forum for Ireland Keynote Seminar: Priorities for healthcare in Ireland 9th November 2016
Priorities for healthcare in Ireland
9th November 2016
CONDITIONS FOR USE OF TRANSCRIPTS:
This document is intended to provide a timely reference for interested parties who are unable to attend the event to which it refers. Some portions are based on transcripts of proceedings and others consist of text submitted by speakers or authors, and are clearly marked as such. As such, apart from where it is indicated that the text was supplied by the speaker, it has not been possible for the transcript to be checked by speakers and so this portion of the document does not represent a formal record of proceedings. Despite best endeavours by Westminster Forum Projects and its suppliers to ensure accuracy, text based on transcription may contain errors which could alter the intended meaning of any portion of the reported content. Anyone who intends to publicly use or refer to any text based on the transcript should make clear that speakers have not had the opportunity for any corrections, or check first with the speaker in question. If in doubt please contact the forum first.
Contents
About this Publication 3
Agenda 4
Session Chair’s opening remarks
Dr Michael Harty TD, Chair, Committee on Health, Houses of the Oireachtas (transcript) 6
‘The Irish Health Service - Future Outlook’
Tony O’Brien, Director General, Health Service Executive (HSE) (transcript) 7
Questions and comments from the floor (transcript) 12
‘Patient safety - Assurance through regulation?’
John Sweeney, Chief Executive Officer and Founder, Health Care Informed (transcript) 17
Questions and comments from the floor (transcript) 21
The future for hospital care - infrastructure, capacity and tackling waiting lists
Ian Carter, Chief Executive Officer, RCSI Hospitals Group (transcript) 23
Dr John Duddy, President, Irish Medical Organisation (transcript) 25
Sheila O’Connor, National Coordinator and Founder, Patient Focus (transcript) 27
Simon Nugent, Chief Executive, Private Hospitals Association (transcript) 29
Questions and comments from the floor (transcript) 31
Session Chair’s closing remarks
Dr Michael Harty TD, Chair, Committee on Health, Houses of the Oireachtas (transcript) 37
Session Chair’s opening remarks
John Brassil TD, Fianna Fáil Spokesperson for Primary Care and Community Services,
Dáil Éireann (transcript) 39
Prospects for Universal Health Care
Dr Stephen Thomas, Director, Centre for Health Policy and Management and
Associate Professor, Trinity College Dublin (transcript) 40
Questions and comments from the floor (transcript) 45
Delivering effective primary and community care
Dr Gerry Cummins, President, Irish College of General Practitioners (transcript) 48
Tadhg Daly, Chief Executive, Nursing Homes Ireland (NHI) (transcript) 51
Michael O’Shea, Centre Director, Applied Research for Connected Health Centre (ARCH) (transcript) 54
Darragh O’Loughlin, Secretary General, Irish Pharmacy Union (IPU) (transcript) 56
Questions and comments from the floor (transcript) 58
Session Chair’s and Policy Forum for Ireland closing remarks
John Brassil TD, Fianna Fáil Spokesperson for Primary Care and Community Services,
Dáil Éireann (transcript) 63
Sean Cudmore, Deputy Editor, Policy Forum for Ireland (transcript) 64
List of Delegates Registered for Seminar 65
Contributor Biographies
Please be advised that speakers’ PowerPoint presentations are included within the transcript itself, just beneath the relevant speaker’s text. Please note that not all speakers are able to grant permission for us to include their slides.
About this Publication
This publication reflects proceedings at the Policy Forum for Ireland Keynote Seminar: Priorities for healthcare in Ireland held on 9th November 2016. The views expressed in the articles are those of the named authors, not those of the Forum or the sponsors, apart from their own articles.
Although Policy Forum for Ireland is grateful to all sponsors for the funding on which we depend, participation in events and publications is never conditional on being a sponsor. As well as funding ongoing operations, sponsorship enables the Forum to distribute complimentary copies of publications, and offer complimentary tickets for events, to Government ministers, parliamentarians and officials most involved in policy.
This publication is copyright. Its copying, in whole or in part, is not permitted without the prior written consent of the publishers. However, extracts of the text may be reproduced for academic or review purposes, subject to the conditions of use outlined in the previous page, providing they are accurate, are not used in a misleading context and the author, their organisation and the Policy Forum for Ireland are acknowledged. We would also appreciate being informed.
Policy Forum for Ireland
UK Headquarters
4 Bracknell Beeches
Old Bracknell Lane West
Bracknell
Berkshire RG12 7BW
T: 01344 864796
F: 01344 420121
Directors
Peter van Gelder
Chris Whitehouse
Policy Forum for Ireland Keynote Seminar: Priorities for healthcare in Ireland
Timing: Morning, Wednesday, 9th November 2016
Venue: Radisson Blu Royal Hotel,Golden Lane, Dublin 8
8.30 - 9.00 Registration and coffee
9.00 - 9.05 Session Chair’s opening remarks
Dr Michael Harty TD, Chair, Committee on Health, Houses of the Oireachtas
9.05 - 9.40 ‘The Irish Health Service - Future Outlook’
Tony O’Brien, Director General, Health Service Executive (HSE)
Questions and comments from the floor
9.40 - 10.00 ‘Patient safety - Assurance through regulation?’
John Sweeney, Chief Executive Officer and Founder, Health Care Informed
Questions and comments from the floor
10.00 - 10.50 The future for hospital care - infrastructure, capacity and tackling waiting lists
Ian Carter, Chief Executive Officer, RCSI Hospitals Group
Dr John Duddy, President, Irish Medical Organisation
Sheila O’Connor, National Coordinator and Founder, Patient Focus
Simon Nugent, Chief Executive, Private Hospitals Association
Questions and comments from the floor
10.50 - 10.55 Session Chair’s closing remarks
Dr Michael Harty TD, Chair, Committee on Health, Houses of the Oireachtas
10.55 - 11.30 Coffee
11.30 - 11.35 Session Chair’s opening remarks
John Brassil TD, Fianna Fáil Spokesperson for Primary Care and Community Services, Dáil Éireann
11.35 - 12.00 Prospects for Universal Health Care
Dr Stephen Thomas, Director, Centre for Health Policy and Management and
Associate Professor, Trinity College Dublin
Questions and comments from the floor
12.00 - 12.55 Delivering effective primary and community care
Dr Gerry Cummins, President, Irish College of General Practitioners
Tadhg Daly, Chief Executive, Nursing Homes Ireland (NHI)
Michael O’Shea, Centre Director, Applied Research for Connected Health Centre (ARCH)
Darragh O’Loughlin, Secretary General, Irish Pharmacy Union (IPU)
Questions and comments from the floor
12.55 - 13.00 Session Chair’s and Policy Forum for Ireland closing remarks
John Brassil TD, Fianna Fáil Spokesperson for Primary Care and Community Services, Dáil Éireann
Sean Cudmore, Deputy Editor, Policy Forum for Ireland
Policy Forum for Ireland opening remarks
Sean Cudmore, Deputy Editor
Ladies and gentlemen, welcome. My name is Sean Cudmore and I’m the Deputy Editor of the Policy Forum for Ireland, and it’s a terrific pleasure to see you all here this morning.
We are waiting for some colleagues to join us, so if you could just allow them to squeeze past and find a seat when they arrive, that would be very, very helpful.
I’m just here to make a few brief business announcements.
First of all, everything which is said in this room this morning will be recorded and later transcribed, and sent to you in the form of a post-event publication in about 10 working days’ time. So if you do have a question or comment to make during the course of the morning, please could you just wait for the microphone, so that we can ensure that you’re on the recording, and also just say your name and organisation.
Also you are more then welcome to tweet with regard to this morning’s proceedings, there’s a hashtag at the bottom of the slide behind me, IrelandPolicy and the wi-fi password is, it’s simply connecting to the Radisson Guest Account and putting in your email address, that should automatically connect you.
So that’s really all from me, we should be in for a terrific morning, and we are in very good hands with both our Chairs. I will hand over now to our Chair for the first half of the morning, Dr Michael Harty TD. Dr Harty.
Session Chair’s opening remarks
Dr Michael Harty TD, Chair, Committee on Health, Houses of the Oireachtas
Thank you very much, it’s an honour to be asked to Chair this session on the priorities for healthcare in Ireland, and I think we are at a crossroads, perhaps another crossroads in the health service in Ireland. There is, in this Dáil a mood for change in the health service which I think has not been there before. I’m a GP and obviously now a TD, I’m a Member of the Committee for the Future of Healthcare which is looking for a vision for change for healthcare over a 10 year period, rather than planning from year to year. I’m also Chair of the Joint Oireachtas Health Committee.
But there is this mood for change in our health service at the moment, this Committee, which is a new innovation, which is trying to tap into all the expertise and resources that are available to us, to present a report, hopefully at the end of January, which we give a vision for our health service over the next 10 years. We’re attempting to move away from year to year planning and year to year budgeting, and have a vision to move incrementally towards a health service which in the future will be effective and efficient.
There are many areas of our health service which work very well and I know the HSE and the Department of Health come in for an inordinate amount of criticism, but there are many areas of our health service which function very well, our cancer care programmes are first class, our intervention cardiology and our ability to treat stroke now have improved out of measure. So there are many areas of our health service which function very well and I think that is something which needs to be recognised.
However there are many areas which are not functioning and certainly the acute care services are not functioning, trolley counts are now the norm in our hospitals, we have an ageing population with multi morbidity, and there is a mood in the Committee, and as each submission comes in, there is a common theme that to build a proper health service we need to have a very strong primary care community care service where people with chronic illness, multi morbidity, our ageing population can be looked after within their own community, rather than having them in the very expensive hospital services. So we do need to develop our primary care services, but apart from developing our primary care services we need to integrate primary care and secondary care. If they are not integrated, if they’re separate as they are at the moment, building resources and putting money into primary care is not going to work. So there has to be an integration of the two, there has to be a free flow of patients between the primary care services and the secondary care services, where people can be streamed into hospital instead of being streamed into a casualty department.
So that’s what we are at at the moment. We have optimism in that Committee that we can produce a report which would bring change.
So our first speaker this morning is Tony O’Brien and I know he needs no introduction, but nevertheless he is the Director General of the HSE. Mr Tony O’Brien, thank you.
‘The Irish Health Service - Future Outlook’
Tony O’Brien, Director General, Health Service Executive (HSE)
Thanks very much Dr Harty. Two days in a row Dr Harty will be Chairing me, I’m at the Oireachtas Committee on Health tomorrow, so probably get more of a grilling there than I will here today perhaps, that will be about current issues, and I’ve been asked today to talk about the future. It’s a very interesting day to be a futurologist, I will say no more.
I’ve got about 20 minutes and I want to cover about 10 things, so 2 minutes a thing, that’s kind of superficial but I think that’s alright for the event today. I’m also going to be giving evidence to the other Committee that Dr Harty has referenced later in the month, and some of these themes will go there as well.
First theme is that of long-term planning, and Dr Harty has referenced this, but in the absence of multiannual evidence informed population based planning, we are not going to build the health service that Ireland needs, that’s why I’m so enthusiastic about the establishment of the Further Health Committee. We need policy aspirations and a vision for healthcare that transcends the electoral cycle and that enables not annual service plans, as we have now, with annual budget processes, but multiannual service plans. We have an environment which essentially drives short-term decision making, where we need one that drives and supports longer term decision making, and which promotes an environment of strategic thought, as they say, based on evidence.
So the outlook for health could now be very bright if we have that type of vision emerging from the process that the Oireachtas is engaged in. The counterpoint is that in the absence of long-term planning as some of my subsequent points, I think, will demonstrate, the outlook is actually quite bleak; don’t want to be doomy and gloomy at this hour of the morning because I believe, as Dr Harty does, that we have huge opportunities.
So the key issue is one of success, it is the fact that we are living longer, we are ageing better, and we are learning to live with ill health, but we are adding about 20,000 over 65s per annum, and our population is projected to increase by 4% or about 188,000 people between now and 2021, by which time there will be an extra 108,000 people aged 65 years or over, and that’s an increase of 20,000 per annum. And there will be about 15,200 additional people aged 85 years and over by 2021, that’s about an extra 3,000 per annum, and that’s all good stuff, but that carries with it particular challenges at the individual level, and particular requirements of a health service, and unless we plan for those we are going to be in significant difficulties.