To ask the Minister for Health his views on the establishment of independent hospital trusts under the universal health insurance system particularly in relation to the agreement of funding and staffing levels; and if he will make a statement on the matter.
Reply from the Minister for Health Dr. James Reilly T.D.
The Government is embarking on a major reform programme for the health service, the aim of which is to deliver a single-tier health system, supported by universal health insurance (UHI), where access is based on need, not on income. Under UHI, everyone will have equal access to a comprehensive package of curative services.
The key changes required to support the reform programme which will pave the way for the introduction of universal health insurance are outlined in the provisions of “Future Health: A Strategic Framework for Reform of the Health Service 2012 – 2015” which was published by the Minister for Health on 15 November 2012.
Earlier this year I appointed Professor John Higgins to chair a Strategic Board on the Establishment of Hospital Groups. Work is continuing on finalising a Draft Report on the recommendations for submission to the Strategic Board. The Report will be submitted to me when the Board have signed off on it and in turn, I will then bring it to Cabinet.
Another key building block for UHI is the development of a ‘Money Follows the Patient’ funding model to replace the current block grant allocation system. Under ‘Money follows the Patient’, providers will be paid for the needs they address, the quantity and quality of the services they provide and the outcomes they deliver. They will be liberated, subject to overall budgetary ceilings, to pursue the most cost-effective means of achieving this standard of performance.
Once the key building blocks have been put in place, it will be possible to proceed with implementation of UHI. Hospitals will then become independent, not-for-profit trusts with managers accountable to their boards. As a precursor to this, it is intended to integrate hospitals into groups on a collaborative administrative basis. The rationale behind the establishment of hospital groups and trusts is to support increased operational autonomy and accountability for hospital services in a way that will drive service reforms and provide the maximum possible benefit to patients. As part of the drive to ensure real accountability, an annual budget and employment ceiling will be developed for each group. Groups will also have the authority to deploy and re-deploy staff across hospitals within the group: this will help to alleviate problems that have arisen in the past in relation to the equitable distribution of health care staff across all hospital sites..
Before Hospital Trusts are finally established, the make-up and functioning of the Groups will be reviewed and if changes prove necessary then they will be made with Government approval when the hospital trusts are being formed.