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Introduction

Why a new Strategy?

Over the last four years health services in Ireland have benefited from the largest ever sustained increase in funding. Facilities are being developed and refurbished, more staff are being hired and the number of people benefiting from health services has increased substantially.

A lot has been achieved, but a lot remains to be done. Very clear deficiencies in services remain which must be addressed. There are unacceptably long waiting times in various parts of the system, important services remain underdeveloped and major demographic challenges must be addressed. By doubling health funding over the last four years, the Government has moved the debate on health funding from resources alone to both resources and reform.

A wide range of issues must be addressed ­ encompassing everything from more effective preventive work through to the development of major acute facilities. This requires a comprehensive blueprint for developments, setting out core principles for the whole system and detailed plans for development and reform. This is why a wide-ranging and ambitious Strategy is required.

For the Strategy to work it must be based on a foundation of solid research and evaluation. This Strategy marks a decisive move away from a short-term and limited approach to planning. An unprecedented series of detailed studies of fundamental issues has been undertaken. These include:

In addition, the Government believes that the public and people working within the health system need to have their say. As a result, the largest consultation process ever undertaken in the preparation of a strategy was implemented. Over 1,800 submissions have been considered, and these were fed directly into the work of those drafting the Strategy.

Setting a new vision

The agenda being set in this Strategy document involves organising the future health system around a new vision:

• A health system that supports and empowers you, your family and community to achieve your full health potential
• A health system that is there when you need it, that is fair, and that you can trust
• A health system that encourages you to have your say, listens to you, and ensures that your views are taken into account.

A number of principles is put forward in support of this vision. These are concerned with:

Flowing directly from these principles are specific actions which have the capacity to deliver the highest quality of care and support to all people. Key examples of this include:

• Primary care services will undergo major development to deliver an integrated community-based service accessible to all on a round-the-clock basis;
• Acute hospital care will be developed and reformed through the creation of 3,000 extra hospital beds for public patients and a range of other measures which will ensure that no public patient will wait longer than 3 months from the date of referral for the scheduling of treatment.
• Continuing care services will undergo a sustained expansion for people with disabilities and older people.
• National treatment protocols will be put in place to ensure that all patients receive a uniformly high quality of care.
• The planning and funding of acute hospital services will be reformed.
• Funding will be more directly linked to service levels and there will be much greater transparency in the planning, funding and delivery of services.

Resourcing health

This Strategy outlines the largest concentrated expansion in services in the history of the Irish health system. Across the full range of care areas, a vision is set out for how the system can develop immediately and over the next decade to deliver high-quality care for all. Proposals are based on detailed research and expert input addressing system-wide as well as programme-specific issues.

The Strategy implies a major increase in the level of health funding. The single most important part of ensuring that this funding can be provided in the coming years is to ensure that we have an economic and fiscal situation which is capable of sustaining such increases. In previous years, Ireland may have had higher percentages of spending on health as a proportion of GNP, but the level of funding was dramatically lower. It is the economic and fiscal policies of recent years which have made possible an unprecedented expansion in health funding.

Over recent years health has been by far the largest beneficiary of new resources available for public services. The Government is committed to keeping health as a key priority area. It is equally committed to working to protect Ireland's economic and fiscal situation, as the key prerequisite to providing the funding required to implement the Strategy.

A full range of options for funding methods has been considered in the preparation of this Strategy. Having considered the alternatives, it is clear that none would deliver significant improvements over the present tax-based method, while each would undermine the ability of the system to deliver the expansion of capacity required both immediately and across the next decade. In addition, the reforms to the current funding system outlined in this Strategy will address clear deficiencies without diverting resources away from the needs of core services.

Implementation

Implementation will require a significant programme of development and growth, reform and modernisation. This programme will be led by the Department of Health and Children, reporting through the Minister to a special sub-committee of the Cabinet. The action programme outlined at Chapter 7 shows how clear leadership, consistent effort and wide collaboration will be required for its implementation.

For its part the Government is committed to continuing to give health the highest priority over the coming period. It anticipates a similar level of commitment from those working in the health system and looks forward to a successful partnership in delivering better health services and improved health outcomes for the population in the years ahead.