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IHCA 2017 Annual Conference Preview

By Dermot - 28th Nov 2018

I am very pleased to again have the opportunity to comment in the <strong><em>Medical Independent</em></strong> in advance of the IHCA’s 2107 Annual Conference. Last year, I referred to the importance of the work of the Oireachtas Committee on the Future of Healthcare in the context of the need for an agreed long-term vision. I believe that stability on leadership of the health services is also important and I am glad to be in a position to progress the reforms necessary to improve our health services and address major issues facing healthcare and the key priorities for me and the Government.

Our improving economy has enabled the health service to achieve much-needed Budget increases in each of the last two years. The provision for 2017, €14.6 billion, represents a 7.4 per cent increase on the original voted Budget for 2016, and a 3.5 per cent increase on the 2016 out-turn. While I and the Government are committed to continuing to increase the level of resources available, we must continue to focus on reforming the system to ensure that the progress made in improving the health of the Irish people continues.

Since taking up the position of Minister, I have been clear that we need more capacity, both beds and staff. This is a problem that is being experienced right across the health system and one which I am taking steps to address. These include a bed capacity review, beginning work on a number of major capital projects, further expanding care in the community and intensifying recruitment and retention efforts. The building of the new National Children’s Hospital is a key development and a priority for me, as it will enable the provision of high-quality tertiary paediatric care. Major steps have been taken in the past 12 months to advance the building of the hospital on the St James’s campus. When complete, the hospital will transform paediatric services in Ireland and deliver care of the highest quality to Irish children. The implementation of the National Cancer Strategy 2017-2026 is also a key priority. Under this Strategy, we continue the improvements that have been achieved and build on these. The centralisation of surgical services for all cancers will continue.

I am pleased that the Oireachtas Committee on the Future of Healthcare has also recognised in its <em>Sláintecare Report</em> the need to address capacity, while progressing the re-orientation of our system towards primary and social care, in line with the thrust of <em>Healthy Ireland</em>. We all have a shared understanding of the key issues that need to be progressed to improve access to our health services. We need to address the impact of our increasing and ageing population and the need to provide more resources, including the need to continue to grow consultant numbers. The number of consultants employed in the public health system continues to increase. At the end of July 2017, there were 2,892 whole-time equivalents, an increase of 105 on the corresponding month in 2016 and 700 in the past decade. However, we remain some way from having a consultant-delivered service.

We need to recruit and retain additional medical staff in order to guarantee the safe current and future functioning of the Irish health service. Last year, I highlighted the need for you to support doctors-in-training. The 2016 <em>Your Training Counts</em> survey showed a 6 per cent increase in the percentage of doctors who do see themselves staying in Ireland in the long-term to 14 per cent. While this is welcome and reflects the significant ongoing efforts being made by a number of stakeholders, including HSE NDTP, the Forum of Irish Postgraduate Medical Training Bodies and the Medical Council, it is important that we continue to improve the learning and workplace environment to support the retention of trainees in the years ahead. I recently attended, for the second time, the annual Medical Careers Day and I was struck by the enthusiasm of the students. It is vitally important that we continue to foster a positive attitude and engage constructively with them. I know that they see mentoring as a pivotal issue and I would ask that you embrace this role.

I know that the cost of clinical indemnity insurance cover has risen considerably in recent years and is a particular concern. I am optimistic, however, that tort reform and patient safety legislative measures in train will result in a lowering of the cost of clinical claims, which should lead to lower indemnity costs in the future. These include: The preparation of regulations on pre-action protocols for clinical negligence actions under the Legal Services Regulation Act 2015; enactment of the Civil Liability Amendment Bill, which will introduce periodic payment orders for catastrophic injury cases; and also mandate for open disclosure and commencement in November of the Medical Practitioners (Amendment) Act 2017 that will make it mandatory for all medical practitioners in Ireland to provide evidence on registration, or on renewal of registration with the Medical Council, of the levels of medical indemnity cover held.

Significant progress has been made in the development and implementation of better models of care and I know that you have a valuable contribution to make to the further development of our health services. I look forward to engaging with you at the AGM and to working with you into the future.

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