Health minister misses 18 out of 20 deadlines in first six months of health reform programme

Thursday 9th May 1013

Just six months after launching his plans for major health service reforms, Minister James Reilly has failed to meet the promised implementation dates for 18 of the 20 actions that were meant to be in place by April 2013, according to IMPACT trade union.

A ‘scorecard’ produced by IMPACT at its Health and Welfare divisional conference in Portlaoise today (Thursday) says that that 12 out of 20 actions promised by the end of March 2013 have yet to be implemented. Another six came late, while just two were implemented on time.

The missed implementation dates relate to measures necessary to facilitate the introduction of universal health insurance by 2016. They include steps towards the creation of new hospital groups and primary care structures, the assessment of the role of local hospitals, the development of new approaches to staff planning and succession, and the establishment of new financial management systems to enable ‘money to follow patients’.

Ministerial plans for the reform of health service structures in advance of the introduction of universal health insurance were launched with a fanfare in mid-November 2012. Future Health: A Strategic Framework for Reform in the Health Service 2012-2015 timetabled actions needed to ensure implementation of new structures and universal health insurance.

But IMPACT national secretary Louise O’Donnell said the early signs showed health minister James Reilly was failing on health reform as most implementation dates slip. “IMPACT believes the minister’s reform plans were flawed from the start. They are incapable of delivering value for money and he chose the wrong model for universal health insurance. But even on his own terms, the implementation record so far suggests that he’s unlikely to deliver universal health insurance,” she said.

IMPACT collated its scorecard by measuring 20 ‘Future Health’ actions due to be implemented by April 2013 against responses it received after it wrote to the Department of Health to get information on how the measures were progressing.

The union says the health minister’s chosen model for universal health insurance is unlikely either to deliver value for money or universal access to healthcare. Meanwhile, a rush to create independent hospital trusts was putting patient safety and service quality at risk.

“IMPACT fully supports the ambition of universal access to health care, but the Government’s model of competing private sector insurers has not been properly tested. If implemented, it is unlikely to deliver equity, value for money, quality or universal access. Lessons from the Netherlands show that a profit-driven commercial model leads to an inequitable and inefficient system of funding, different tiers of entitlement and rising hospital deficits,” said Ms O’Donnell.

Over 200 delegates at the conference passed a motion seeking information on “the real cost of the Government’s proposed competing private insurance model for providing universal health insurance and the impact this will have on local services.”

IMPACT represents some 30,000 health workers including health and social care professionals, clerical and administrative staff, and technical grades.

Note for editors

Last November, IMPACT commissioned its own report, which found hospital trusts were being established before funding and staffing levels were agreed, and without proper integration with primary healthcare and other non-hospital services. The union has called for the roll-out of hospital trusts to be halted until these issues are resolved.

The Future of Healthcare in Ireland, by independent healthcare expert Dr Jane Pillinger, also said the Government had based its approach to universal health insurance on policy in The Netherlands, where a system of competing private insurers has created an inequitable and inefficient system of funding, different tiers of entitlement, rising hospital deficits, and even bankrupt hospitals. Inherent financial incentives to discharge patients early had also left The Netherlands with one of the highest hospital re-admission rates inEurope because more people experience post-discharge complications.

IMPACT wants the Government to evaluate an alternative ‘single-payer’ social insurance model like those used inFrance,Germanyand Nordic countries. Ms O’Donnell told today’s conference that the ‘competing insurers’ model should be shelved until all the options were evaluated in terms of quality, equity, access to services, and medium and long term value-for-money.