Over the past 12 months the Department of Health has developed a range of policies and regulations to improve our Health Service.
Below is a list of some developments made over the course of 2021.
Public Health (Alcohol) Act
Minister for Health, Stephen Donnelly TD welcomed the Regulations under the Public Health (Alcohol) Act which are designed to restrict price promotions of alcohol products. From Monday 11 January 2021, the ‘Sale and Supply of Alcohol Products Regulations’ prohibits loyalty card points from being awarded or used for the purchase of alcohol products. They also ban the selling of an alcohol product at a reduced price for a limited period or because it is sold with another product or service.
Medicinal Cannabis Access Programme
Minister Donnelly announced the provision for the delivery and funding of the Medicinal Cannabis Access Programme.
Once suitable medical cannabis products are made available by suppliers, the Access Programme will make it possible for a medical consultant to prescribe a listed cannabis-based treatment for a patient under his or her care for the following medical conditions, where the patient has failed to respond to standard treatments:
- spasticity associated with multiple sclerosis
- intractable nausea and vomiting associated with chemotherapy
- severe, refractory (treatment-resistant) epilepsy
Minister Donnelly secured government approval to expand access to medical cards, making them available to all those who are terminally ill and have a prognosis of up to 24 months.
The new arrangement will confer a benefit to patients with diagnoses across a range of specialties such as:
Obesity Policy and Action Plan
The Department of Health published an Implementation Progress Report on “A Healthy Weight for Ireland”, Ireland’s national Obesity Policy and Action Plan (OPAP). The report outlines progress made, and actions taken across the 60 action areas of the OPAP, from September 2016 to the end of 2019. This sets out how healthcare for children, young people and adults living with overweight and obesity in Ireland should be organised and resourced now and into the future. The actions described involve input from a wide range of stakeholders, which illustrates the multi-sectoral and cross-governmental nature of the Obesity Policy and Action Plan.
Significant achievements highlighted in the Progress Report are:
- the introduction of a Sugar-Sweetened Drinks Tax, which commenced on 1 May 2018
- the appointment of a National Clinical Lead for Obesity in the HSE, with work advanced on the development of a Model of Care for the management of overweight and obesity
- the publication of new Healthy Eating Guidelines, Food Pyramid and supporting resources (recently complemented by the Healthy Eating Guidelines for 1–4-year-olds)
- the development of Nutrition Standards for schools
120 Medical Intern Posts announced
120 medical intern posts plus additional postgraduate training places and Post CSCST Fellowship posts for July 2021 were announced. Minister Donnelly is committed to increasing the medical workforce and this approach is a positive step as it offers more opportunities for training doctors, including those at a senior level.
Minister Donnelly has agreed that a permanent increase in intern posts cannot be considered in isolation and the full journey of postgraduate training needed to be considered to ensure alignment with medical workforce planning and the next steps in postgraduate training pathway.
The Minister has agreed the following measures to support postgraduate medical training in Ireland:
- an increase of interns for July 2021 to 854 places
- introduction of a period of an overlap of one week between exiting and incoming interns
- establishment of 12 De Novo Training Posts
- conversion of 40 Non-Training Posts to Training Posts
- permanent establishment of 40 Post CSCST Fellowships
The new measures are estimated to cost approximately €11.4m over the next two years with €4.4m to be funded in 2021.
Funding for ambulatory gynaecology services and enhanced endometriosis service
Minister Donnelly, announced details of two areas to be funded under the recently established €5 million Women’s Health Fund:
- two community-based Ambulatory Gynaecology Services governed by two acute hospitals (Tallaght University Hospital, and University Maternity Hospital Limerick)
- expansion of the endometriosis service at Tallaght University Hospital (TUH) to deliver a specialist endometriosis centre for the management and treatment of all forms of endometriosis, with particular focus on advanced and complex cases for which there is no ready access in Ireland
Reformed Consultant-led Public Health Model in Ireland
The Minister for Health announced that agreement has been reached with the Irish Medical Organisation (IMO) on a reformed public health model in Ireland. It is understood that the IMO will recommend the Agreement to their members who will ballot on it later in 2021.
The enhanced service delivery model radically changes the governance and operating structure within Public Health, introducing a more fit-for-purpose National and Regional management structure across each of the pillars of Public Health – a consultant led ‘hub-and-spoke’ structure as envisaged by the Crowe Horwath Report.
As a result, the Phase 1 priority posts for recruitment through open competitive processes will be in the Health Protection pillar.
A considerable amount of work has been completed in the design of the new model and the department and the HSE are excited to continue to work with our public health physicians to now implement the new model.
The next step will involve the HSE commencing an open recruitment process for Consultants in Public Health Medicine to fill the prioritised posts.
Last year’s Budget made funding available for a large expansion of the health sector which has seen it grow by 4% so far in 2021. This large expansion will continue in 2022.
Healthy Ireland Strategic Action Plan 2021-25
Government launched the Healthy Ireland Strategic Action Plan 2021-25. The core component of the implementation of Sláintecare, this Healthy Ireland Strategy will have a particular emphasis on reducing inequalities. It will involve a comprehensive cross-government approach, with a total of 14 government departments responsible for implementing actions for the next 5 years.
Among some of the targets for the next 3 years Healthy Ireland will aim to deliver are:
- implementation of a healthy campus programme in 30 third level institutions
- help 4,500 people to live in their own home with dignity and independence through the Sláintecare age-friendly healthy homes scheme
- develop new policies and action plans addressing sexual health, physical activity, nutrition, obesity, and mental health promotion
- add 500 more clubs to the GAA health clubs’ model, as well as drive participation amongst other sporting organisations
- by 2022 develop 18 Sláintecare healthy communities in disadvantaged areas
Final Evaluation Report on ANPs
Minister Donnelly published the Final Evaluation Report, outlining the many benefits of Advanced Nursing Practitioners.
An Advanced Nurse Practitioner (ANP) is a highly skilled and experienced expert in clinical practice and provides a complete episode of care in response to patient needs which includes; patient assessment informed by relevant examinations and diagnostics, medication prescribing, patient referral and follow up as required.
The report demonstrates the positive impacts for patients and services through implementation of Advanced Nurse Practitioner roles:
- each ANP removes on average 3.9 patients per week from specialist waiting lists
- on average 4.3 patients per ANP are avoiding hospital admission on a weekly basis
- there is a reduction in overall Patient Experience Times (PET) of up to 2 hours 43 minutes for patients seen in emergency care areas which include ANPs as part of the care delivery model
- over 95% of patients reporting a positive experience of the care received from an ANP
Sláintecare Implementation Strategy and Action Plan 2021-2023
Sláintecare is about delivering a safe, quality health and social care service that meets the needs of our growing population, and attracts and retains the very best healthcare clinicians, managers, and staff.
The new Sláintecare Implementation Strategy and Action Plan 2021-2023 sets out the priorities and actions for the next phase of the reform programme. The aim is to deliver a universal health service that offers the right care, in the right place, at the right time, at low or no cost.
Over the next three years, Sláintecare will work with partners to:
- implement a multi annual plan to reduce waiting lists in hospital and the community
- begin construction on new elective hospitals in Cork, Dublin and Galway
- roll-out the Sláintecare Consultant Contract, permitting public-only work in public hospitals
- hire 7,000 new community-based healthcare staff
- deliver 31 new Primary Care Centres, creating a total of 173 around the country
- invest in 32 Community Specialist Hubs for older people and people living with chronic disease
- provide additional health resources in 18 communities of most disadvantage across Ireland to address health inequalities
- mainstream access for patients to direct diagnostics through GPs
- develop Policy Proposals for achieving Universal Eligibility
- create 6 new Regional Health Areas
- establish 96 new Community Healthcare Networks to support integrated care across primary, community and acute care
- invest in Healthy Ireland to keep people well in their own communities
- scale Innovation projects that support patient safety initiatives
- put in place a digital Shared Care Record so people have access to their health records no matter where they are being treated
Healthy Age Friendly Homes
Sláintecare and Age Friendly Ireland / Meath County Council are responsible for rolling out this joint programme entitled ‘Healthy Age Friendly Homes’, across nine Local Authority areas. This is a new initiative, funded by Sláintecare, that aims to enable older people to continue living in their homes or in a home more suited to their needs.
Ultimately this approach aims to:
- support the avoidance of early or premature admission to long term residential care
- enable older people to continue living in their homes or in a home more suited to their needs (Rightsizing)
- live with a sense of independence and autonomy
- be and feel part of their communities
Additional Funding for Primary Care Psychology Services
Minister Butler announced the approval of up to €4 million to reduce the number of children and young people under 18 waiting more than 12 months to access Primary Care Psychology.
This funding will enable the implementation of measures and initiatives in Community Healthcare Organisations (CHOs) to deliver a short-term impact and reduce these waiting lists throughout the remainder of 2021.
Minister Donnelly published a report of a ‘radical listening’ exercise to hear women’s voices on women’s health through research commissioned by the Women’s Health Taskforce this year.
Led by independent researchers, over 270 women participated in these discussions from all over Ireland, sharing their experiences of, and wishes for, the Irish health system. The research was carried out in three stages, beginning in mid-2020 and finishing in June 2021, involving social and media listening; hearing women’s stories and experiences; and national workshops with women.
The report is the result of a priority project for Women’s Health Taskforce and provides invaluable insight into women’s experiences of healthcare in Ireland. Women highlight some positive experiences but also important issues that they want to see improved in particular around: information, respect and dignity, and access.
Health and Wellbeing Services
Minister Donnelly and Minister Feighan launched a new €13m initiative to support increased health and wellbeing services to 19 communities in Ireland. Healthy Communities is a new cross-government initiative to deliver increased health and wellbeing services to 19 community areas across Ireland. The programme will be delivered in partnership with the HSE, local authorities, local communities, statutory, voluntary and community groups. The investment will fund new posts including staff working at community level to engage, support and coordinate these activities in an effective manner.
Free Contraception Scheme for Women
Funding secured by Minister Donnelly in Budget 2022 will see this scheme gradually being introduced starting with younger women aged 17-25 who are least likely to be financially independent and where cost has been shown to be a greater barrier to access contraception.
Implementation Plan for the National Maternity Strategy – Creating a Better Future Together 2016-2026
In line with HIQA’s recommendation in its 2020 report into maternity services and considering experience and changes that have occurred since the launch of the Strategy in 2016, the National Women & Infants Health Programme (NWIHP) revised the original Implementation Plan.
The revised Plan sets out in detail the roadmap to ensure the National Maternity Strategy is implemented in full within the timeframe originally intended. It presents clearly all outstanding actions, their status and the timeframe required for each.
Framework Agreements on Pricing and Supply of Medicines 2021 – 2025
The Minister for Health, Stephen Donnelly TD announced two new Framework Agreements on Pricing and Supply of Medicines 2021-2025.
The multiannual agreements with the Irish Pharmaceutical Healthcare Association (IPHA) and Medicines for Ireland (MFI) represent an important step in reducing the cost of medicines and improving access to innovative new medicines for patients.
The new deals will deliver:
- improved access for patients to new and innovative medicines
- reductions in the cost of existing medicines
- an easing of financial pressure on the health services into the future
It is estimated that this will result in the State paying between €600 million and €700 million less for medicines than it would otherwise.
Healthy Ireland Survey 2021
Minister Donnelly and Minister Feighan launched the results of the Healthy Ireland Survey 2021.The survey represents a detailed insight of a time interval during which necessary COVID-19 restrictions had a significant impact on the health and wellbeing of the people of Ireland.
A Roadmap for Food Product Reformulation in Ireland
Minister Donnelly and Minister Feighan launched A Roadmap for Food Product Reformulation in Ireland and announced the establishment of a Food Reformulation Task Force to implement the Roadmap.
The publication of the Reformulation Roadmap is a core element of Ireland’s Obesity Policy and Action Plan setting targets for the reduction of the levels of saturated fats, sugar, salt and calories in processed foods.
The Roadmap, a 2021 action in the Healthy Ireland Strategic Action Plan 2021-2025 has been prepared by the Reformulation Sub-Group of the Obesity Policy Implementation Oversight Group, chaired by Professor Ivan Perry of UCC. The work of the group included a consultation process with the food and drinks industry. Foods that are high in fat, sugar and salt are overconsumed in Ireland, and many other countries, which contributes to high levels of non-communicable diseases including high blood pressure, Type 2 diabetes and obesity.