January 31, 2014 § Leave a comment
The consultation process on the content and scope of a new GP contract for the provision of GP care, free at the point of use, for all children aged under six years of age began today.
This is the first phase in the provision of a universal GP service for the entire population as set out in the Programme for Government and in Future Health.
A draft contract document has been developed, which will underpin the provision of GP care for children aged under six. The consultation process starting today relates to the content and scope of this contract. New enabling legislation is also being drafted.
Today I met with key stakeholders – the Irish College of General Practitioners, the Irish Medical Organisation and the National Association of General Practitioners – to brief them on Government policy concerning the introduction of a universal GP service without fees, and in particular on the first phase covering children aged under six. The meetings included a presentation on the key features of the draft contract.
The views of the general public and interested bodies are also being invited. The draft contract is available for review on the HSE website at www.hse.ie/under6contract. The closing date for receipt of written submissions by the HSE is February 21st 2014. The address is:
The Office of the Assistant National Director, Contracts,
Health Service Executive
Primary Care Division
St Loman’s Hospital
or by email to email@example.com
I look forward to a constructive engagement over the coming weeks with GPs and their representatives on the scope of the contract. I am also interested in hearing the views of the general public on the type of service to be delivered to children under this new arrangement. This is the first public consultation of its kind and I am sure that this broad engagement will be helpful to all involved.
January 28, 2014 § 1 Comment
On a personal level and as a local TD I was sad to hear the news that Mount Carmel is to be placed in liquidation.
This is a difficult time for all of the hard working and committed staff at the hospital. Mount Carmel is a Churchtown landmark and an important local employer.
I understand that it wasn’t possible for the State to purchase the hospital as a going concern without involving additional financial exposure to the taxpayer.
The HSE is now working with the staff of the hospital to ensure that all patients’ needs are met in the short term and that arrangements are made with alternative hospitals so as to ensure as seamless a transition as possible for patients in accordance with their choice.
The move of the National Maternity Hospital from Holles Street Hospital to the St. Vincent’s campus will provide for additional capacity for maternity services in the future. Birth rates have fallen significantly in recent years and the CSO projects that birth rates will continue to fall at least until the early 2020s.
I met with trade union representatives of Mount Carmel this week. I assured them of my intention to do everything possible to support the staff at this very stressful time.
January 23, 2014 § Leave a comment
There is a tremendous opportunity for South Dublin sports clubs and organisations to secure funding with the 2014 Sports Capital Programme. The fund totals €40m and I’d recommend local clubs to study the detail of the Programme and to get their applications in as soon as possible.
The application process is competitive and there’s already tremendous interest in it. In fact, more than a thousand organisations have registered already. That’s why it’s vital for clubs and groups applying for the 2014 scheme to get registered immediately. The deadline for registering is Friday February 7th.
Applications can only be made online this year and the deadline for completed applications is 5pm on Friday February 28th. All interested bodies should go to www.sportscapitalprogramme.ie to register and make an application.
The Sports Capital Fund is designed to assist organisations in developing high quality, safe and well-designed facilities to help maximise participation in sport and physical recreation.
I’m delighted that this Government, who reinstated the Sports Capital Fund last year, have decided to inject further funding to local sports. I view the investment in community sporting facilities as vital to assisting in the improvement of the nation’s health and wellbeing.
Best of luck to all of the local sports clubs who apply.
January 22, 2014 § Leave a comment
Ireland needs to make radical choices to improve its health and well-being with society taking responsibility and government providing free GP cover and tackling the key challenges of tobacco and alcohol.
This Government’s vision for primary healthcare in Ireland is the development of a single-tier healthcare system where access is based on medical need and not on ability to pay.
Primary care focuses on keeping people healthy and preventing illness rather than simply curing sickness after it has developed. Ideally, primary care is situated locally, in the community or even in the homes of the patient and away from a hospital setting.
Ireland is at a crossroads when it comes to health policy. There are many challenges facing our health system. These include but are not limited to constrained financial resources, a population over 65 years of age that will more than double over the next 30 years, and a baby boom. Chronic diseases and disabilities related to poor diet, smoking, alcohol misuse and physical inactivity are also on the rise.
It’s evident that we’re going to need to get more out of our health system for less. If our health system feels over-burdened now, this will only get worse unless radical strategic health choices and investment are made now.
To make our Health Service efficient, effective and fair requires not only considerable financial investment but also a major shift in focus from hospital-based care to primary care. The current budgetary constraints must not deter innovation in our health system. The policy decisions we make now will determine the health and well-being of our society for many decades to come.
Better GP care
The Budget announcement to extend GP access to children aged five and under is a hugely significant move. It is now being brought forward in the form of legislation. But it’s just the beginning. It is only the first step in the implementation of a policy of universal primary care.
Too many people in Ireland avoid going to their GP for essential medical care as they simply cannot afford the €50-60 fee. This ends up costing the Health Service more, as the monitoring and treatment of preventable diseases is delayed. As a result, late secondary care ensues. If the barrier of GP fees is removed, people are far more likely to address a medical issue at its earliest stage – when it’s easiest to solve. The earlier the diagnosis and intervention, the better the outcome and the cheaper the treatment.
There’s a reason GP care without fees is a norm in Northern Ireland, Great Britain and across Europe – because it makes sense and it works.
But long-lasting health reform requires even more than restructuring our health services to a primary care focus. If we keep going along the current path, it is estimated that most OECD countries will spend more than 20 per cent of GDP on health care by 2050. A real challenge is how we as a society can work together to find ways to encourage individuals to take more responsibility for the management of their own health.
This Government has been making a concerted effort to empower people to take control and responsibility for their well-being. ‘Healthy Ireland’ is the government framework for action, launched earlier this year, to improve the health and well-being of people living in this country over the coming generation.
Actions under way include a national plan for physical activity and the launch of a communications campaign to address childhood obesity. Parents are being urged to make practical changes to everyday lifestyle habits – such as portion sizes, drinks and screen time – to make a difference to the health and well-being of children and combat Ireland’s high levels of childhood overweight and obesity.
‘Tobacco Free Ireland by 2025’ is the new tobacco policy which was launched last month by Minister Reilly. The policy has many recommendations with the overall aim of de-normalising smoking in Irish society.
I was very pleased to bring to Cabinet a package of measures to address the serious over-consumption of alcohol in this country. To implement these measures, the Government approved the drafting of the first piece of public health legislation to address the problem of alcohol misuse: the Public Health (Alcohol) Bill.
Ireland’s drinking patterns are complicated and there’s no single silver bullet policy that will resolve over consumption of alcohol overnight. That’s why I proposed to government a wide-ranging package of measures to reduce alcohol consumption, including the introduction of minimum unit pricing, the separation of the sale of alcohol from other products, reformed health labelling of alcohol products and the regulation of marketing and advertising of alcohol, including sports sponsorship.
There’s a lot more work to be done in realising our vision of a health system in Ireland grounded in universal primary care, where citizens take an informed and pro-active interest in their health and well-being.
I’m heartened that the first steps are being taken in this regard. I look forward to children aged five and under being the first to enjoy the benefits of free primary care access. This is the first but crucial step in creating a sustainable health system fit for the increasingly complex needs of twenty-first century Ireland.
Alex White is Labour Party TD for Dublin South and Minister of State at the Department of Health with responsibility for Primary Care.
This article first appeared in Eolas Magazine: eolasmagazine.ie
January 22, 2014 § Leave a comment
I was delighted to attend last week’s Labour Party Candidate Selection Convention for Dublin South. Cllr Grace Tallon and Peter Leonard have been selected to run in Dundrum, Cllr Lettie McCarthy and Peter O’Brien in Glencullen and Cllr Richard Humphreys in Stillorgan. These are five great candidates who are working hard to serve our local communities. I’m looking forward to supporting them in their upcoming local election campaigns in May 2014. The local and European elections will be held on Friday, May 23rd 2014.
January 16, 2014 § Leave a comment
Good morning Ladies and Gentleman. I am very pleased so many of you have been able to join us this morning, especially people who have travelled some distance to be here. Today’s conference is designed to offer a practical opportunity for the advancement of our common goals and objectives, and I am sure it will be of great benefit to us all.
Can I, at the outset, thank the Tánaiste, Eamon Gilmore, for his introductory remarks and for agreeing to open our conference this morning; I’m delighted he was able to join us given his busy schedule. I am extremely grateful for his commitment, and that of the Government, to the National Drugs Strategy, and I thank him for his words of encouragement as we face into our morning’s work.
Today’s conference is the culmination of an extended period of consultation and reflection. My intention is that it will afford us all the chance to reflect on how we can collaborate effectively under our new structures, and begin to plan for how best we can address new and emerging issues in drug addiction and alcohol misuse.
Reflections on my period in office
Since I was appointed to the office of Minister of State at the Department of Health, over 15 months ago, I have been privileged to see and hear at close quarters the outstanding work being conducted by dedicated people and organisations up and down the country.
And I have witnessed the tremendous commitment and effort of those working hard to get their lives back on track, and away from the scourge of drugs and alcohol addiction and misuse.
Soon after taking up this role I announced the conclusions of a review of the Drugs Task Forces undertaken by the Department at the request of my predecessor in office.
That Review recommended a series of reforms to better equip the Drugs Task Forces in their response to the current pattern of substance misuse. The key changes proposed included:
- Drugs Task Forces to be renamed “Drug and Alcohol Task Forces” reflecting their current role in tackling substance misuse, including alcohol;
- a National Coordinating Committee to be established, to guide the work of the Drug and Alcohol Task Forces, and to ensure the ongoing implementation of the National Drugs Strategy;
- clearer terms of reference and corporate governance guidelines for Drug and Alcohol Task Forces;
- measures to encourage more Public Representative involvement in the work of Drug and Alcohol Task Forces; and
- a review of the number and boundaries of Drugs Task Forces, mainly in Dublin.
While other important matters have been progressed, the implementation of these specific recommendations has been delayed until now for a number of reasons. Later this morning, our colleague Susan Scally will outline the role of the new National Co-ordinating Committee – prescribed in that report – and how we intend to proceed with the implementation of the various recommendations over the coming months. I am happy to confirm this morning that the new Co-ordinating Committee is due to hold its inaugural meeting this day week, January 23rd.
I have no doubt that while these recommendations will take some time to take hold, ultimately they will foster a much greater sense of cohesion between the national structures and the Drugs Task Forces. This increased cohesion will, I hope, facilitate a constant two-way flow of information, with policy makers, and practitioners on the ground, working together and learning from one another, providing each other with valuable insights into their work. This, as you know, was one of the main reasons for adopting an inter-agency approach in the first place. So we must strive together to ensure that this method is maintained, and improved where possible, in order more effectively to tackle emerging issues, recognise new challenges, and advance new practices.
Early in 2013, I had the opportunity to oversee the delivery of the 2012 Progress Report on the 2009-2016 National Drugs Strategy. Despite some reservations on my part, I think that Progress Report very clearly demonstrates that significant progress has been made on strategic goals across the five central pillars of the national strategy. The Progress Report also emphasised the potential of a sustained partnership approach in achieving even greater success.
However, it was clear also that there was a need for me as Minister to embark on a programme of formal meetings with all of the key contributors to the National Drugs Strategy – to take a step back from the daily challenges, and figure out how we can renew, or breath new life into this collective commitment which has been so essential to the implementation of the National Drugs Strategy.
This, I understand, was the first time since 2009 that such a comprehensive engagement with all of the parties has been undertaken. I am pleased to say that we have now completed a full programme, concluding just yesterday morning when I had a very useful and informative meeting with the Commissioner of An Garda Síochana.
The bilateral meetings presented an opportunity for the main players to reaffirm their commitment to their own respective roles. Most importantly, they offered the chance to explore where relationships across agencies and departments, offices and services, could be deepened and strengthened. In her presentation this morning my colleague Susan Scally will summarise the principal outcomes of that consultation process.
And here I would like to acknowledge the tremendous efforts of the DPU team at the Department, led by Susan Scally – not just for facilitating that process, but also for their sterling work in arranging today’s conference.
With any strategy implemented over such a long period and, as in this case, involving such frequent changes in leadership, it can be hard to maintain momentum. However, what I have found without exception, is an absolute and resolute commitment to realising the core Strategy objectives across the five pillars.
I have also encountered a genuine resolve to tackle obstacles that may stand in the way of progress. For example:
– Minister Joan Burton’s flexibility regarding the purpose of the CE Scheme, and her willingness to engage with stakeholders to pilot new models which could be of real benefit to our sector,
– or Minister Frances Fitzgerald, whose work will transform our focus on services to children, with considerable potential also for our agenda.
I have also heard from the community and voluntary sectors, many of whose members are coming forward with progressive ideas and innovative thinking, such as:
– the willingness of the voluntary sector to promote open procurement of public funding;
– innovations within the prison services, and their keen awareness of the obstacles faced by those seeking a substance-free life after release; and
– the balanced conversation promoted by the community sector on the issue of decriminalisation.
I am greatly encouraged in my belief that despite significant ongoing problems on funding and resources, much can, and will be achieved throughout the latter half of the Strategy’s implementation.
In my first year as Minister of State at the Department of Health, I worked steadfastly to deliver a package of measures to be included in the first ever Public Health (Alcohol) Bill. I was delighted when this was formally approved by Government, and I’d like to thank Dr. Tony Holohan and his dedicated team in the Department of Health for their hard work in helping make this happen.
Government recognises the severe consequences of the misuse of alcohol – including deaths, injuries, and social and financial problems – and has determined to take action to address this problem.
The package of measures to be implemented was the result of intensive discussions across Government departments and in the relevant Cabinet Committee on Social Policy. It will include provision for minimum unit pricing for alcohol products and the regulation of advertising and marketing of alcohol, as recommended in the National Substance Misuse Strategy.
The Steering Group reported that 1.5 million Irish drinkers drink in a harmful pattern. As you’re all aware, alcohol misuse remains one of our biggest challenges touching every community across the country. The statistics are stark:
- Alcohol was responsible for at least 88 deaths every month in 2008; 1 in 4 deaths in young men were estimated to be due to alcohol,
- Alcohol is a contributory factor in half of all suicides and in deliberate self-harm; it also increases the risk of more than 60 medical conditions – such as cancers;
- It is associated with 2000 beds being occupied every night in Irish acute hospitals;
- Alcohol It is a trigger in a third of domestic abuse cases;
- Figures from 2007, show that alcohol related illness costs the healthcare system €1.2 billion, and alcohol-related crime cost an estimated €1.19 billion.
The principal objective of the Public Health (Alcohol) Bill will be to reduce Ireland’s excessive patterns of alcohol consumption from the 2011 average of over 11 litres of pure alcohol per year consumed per-capita, to the OECD average of 9.1 litres of alcohol by 2020. By reducing alcohol consumption we can also reduce the social, economic and health harms associated with alcohol misuse.
Recognising the significance of the Community and Voluntary sectors’ contribution to successive National Drugs Strategies, I hope that today we can begin to draw more closely on your valuable local experience and insights in order to address how we might realise this ambitious target.
Unlike problem drug use, which historically has been clustered and correlated with other social problems and issues, alcohol problems are dispersed more evenly throughout society, although their impact is most acutely felt where there are other existing social and familial problems – for example poverty, family breakdown and child neglect and abuse.
The Task Forces at this stage have a strong track record in bringing together key players in dealing with drug problems, and it now behoves us to find a way to deploy this experience more strategically in relation to alcohol, thereby building on strengths, and utilising capacities within a broader field.
At government level we have been engaged in developing an across-the-board national response. Although good progress has been made, it is clear that this is a complex process, particularly having regard to issues such as sports funding, the broader economic dimension and jobs, as well as the fundamental public health imperative, which of course is our principal concern.
In this respect, national government obviously needs to lead, and we will do so, but our efforts need to be complemented by a new commitment across society, including more localised, strategic initiatives. It seems to me that the Task Forces are in an ideal position to bring focus to this dimension.
Given what I said earlier about the less “clustered” character of the alcohol problem, it may be worth considering whether Task Forces might link together or as appropriate, with leaders from Local Councils, HSE, Gardaí, Child and Family Agency and other relevant interests to develop initiatives at regional or City levels (or large sub-city areas – for example Dublin North, Dublin South, Dublin West, Fingal, South Dublin County and Dunlaoghaire/Rathdown). This could facilitate initiatives for tackling alcohol problems as a mainstream issue in these larger areas, and in society more generally.
I’m sure many of you have ideas that can be explored and developed, and I look forward very much to listening to your observations and insights. I also look forward to the presentations later from a number of contributors including:
- the Alcohol Forum,
- the Ballymun Local Task Drug Force, and
- the Galway City Alcohol Strategy.
They will each give us a brief insight into a number of local initiatives that have already commenced. I am also looking forward to learning more about the ‘Hello Sunday Morning’ initiative, which will illustrate the potential that social media can bring to reaching new audiences and changing our attitudes and behaviours.
Your remarkable contribution stretches back to the pivotal intervention of the First Ministerial Task Force established by my colleague, Pat Rabbitte, in 1996. This was at the time of a real crisis – the heroin crisis – that so blighted our major urban communities.
At the heart of that intervention was a principle, articulated by the Combat Poverty Agency and informed by research to the effect that:–
“strategies, which consult with and actively encourage the involvement of local people are most likely to succeed”.
Today, while some of the same challenges remain, our drug and alcohol problem has evolved significantly, and has become increasingly more complex. However, our core approach to tackling these problems endures, and must endure.
So – I hope that as a result of today’s conference, you will:
- learn and understand more about our new structures;
- hear from our colleagues, who are using new and innovative techniques on the ground;
- agree on common objectives and desired outcomes on our approach to alcohol misuse,
- most importantly, I hope that today’s gathering will renew our collective faith in working together with common purpose, enabling us to meet today’s challenges head-on with progressive ideas, innovative thinking and renewed vigour.
Thank you for your attention.