Deadlines and deficits key to Reilly road map

ANALYSIS:The 'Future Health' plan has the potential to change the face of Irish medicine

Minister for Health James Reilly has always had big plans for the health service, but now they are in book form.

Future Health, published yesterday, is a 52-page road map for the reform of the way health is provided in Ireland. If implemented, it has the potential to change the face of Irish medicine by improving services and making the service fairer and more accessible.

The problem for Dr Reilly is that the story so far is one of missed deadlines and soaring deficits, punctuated by occasional successes. This probably explained the scepticism among journalists to whom he presented the plan yesterday in the Department of Health.

But first, the vision. The plan is for a new focus on keeping people healthy while moving away from simply treating ill people. There will also be a move away from the current hospital-centred model of care towards treating people as close to home as possible.

The minister is big on structural change, starting with the Health Service Executive, which is being merged back into the department. The big goal is the introduction of universal health insurance (UHI) in 2016 and, a year earlier, free GP care for all.

This is the policy set out in the programme for government but in this document timelines are set out for many of these commitments. The extension of Breast Check to women aged 65-69 years will start in 2014, for example.

But what of the promises made in the programme for government? It promises that access to free primary care for people with long-term illnesses would happen in the first year of government.

Yesterday, we heard this won’t happen until the middle of next year, which is 15 months later than promised. Yet when The Irish Times reported last September that this policy was running a year late, the Minister claimed the following day it was “still on track”.

Another report Dr Reilly and his Ministers of State were quick to reject related to the employment of extra primary care and mental health staff. The programme promised ring-fenced funding for mental health staff, and special funds were allocated for primary care teams.

Yet we learned yesterday that none of the primary care staff has been appointed and no one could say how many of the mental health workers have started. Minister of State Kathleen Lynch promised that most of the mental health staff will have started by December 10th, which means there will be no salary drawdown in this year. In both cases, the money has gone to offset the HSE overspend but Ministers seem to have great difficulty saying this.

Under questioning, Dr Reilly was forced to admit yesterday that most of the new document “has all been announced before” but he said the timelines were more concrete now. Asked to identify one new detail about his plans for UHI, he was unable to provide an answer.