Web-economic-crisis-health-systems-and-health-web
Web-economic-crisis-health-systems-and-health-web Web-economic-crisis-health-systems-and-health-web
Country profiles of health system responses to the crisis | Ireland 409 Payment to providers • From 2008, annual fee to GPs who treat medical card holders reduced. • From 2009, reduction of 8% on all professional fees and cut to pharmacy fees of 24–34%. Further cuts in fees of 5% for health professionals were introduced in 2010 and 2011. In 2013 budget, professional fees for health services providers were to be further reduced. It is estimated that pay-related savings will reach €308 million in 2013. Overhead costs: restructuring the Ministry of Health and purchasing agencies • HSE commitment in 2009 to reduce administrative, management and advertising costs by at least 3%. • Cuts in administrative spending introduced in 2010 budget, including reducing HSE staff by 6000 (€300 million) plus additional efficiencies in the HSE (€90 million). • Cuts in administration (€43 million) proposed in 2011 budget. • Administrative savings in the Department of Health were to total €20 million. Provider infrastructure and capital investment • Measures to provide more services with fewer resources: hospital day care increased by 5% in the first six months of 2009 relative to 2008 and above the 2009 target; outpatient appointments increased by 3% between the first six months of 2008 and 2009 and the number of new outpatient attendances increased by 6% in the same period; hospital capacity reduced by 519 beds between January and July 2009. • The approval (subject to planning permission) for a new National Children's Hospital at the expected cost of €500 million was announced in November 2012. It is planned to be completed by 2018 (at the latest) and will merge the three existing children's hospitals. Priority setting or protocols to change access to treatments, coordination of care and patterns of use • Since 2008–2009, 31 clinical care programmes have been in place that utilize a model of care devised for improving the quality of cancer care; this model is now being applied to all diseases and conditions in all health care settings. Many of the efficiencies gained in 2012 are attributed to service improvements brought about by the clinical care programmes. Waiting times • Between January and September 2012, the number of people waiting on trolleys in emergency departments fell by 24%, the number of adults
410 Economic crisis, health systems and health in Europe: country experience waiting for elective treatment in public hospitals fell by 86% (waits over 12 months), 92% (waits over 9 months), 44% (waits over 6 months) and around 33% (waits over 3 months), reflecting political priority to reduce waiting times by increasing hospital activity through clinical care programmes, which had been implemented since 2010; however, there are 388 438 people waiting for outpatient appointments, waiting times for community services (e.g. physiotherapy) have increased and in 2012 there were 2.5 million fewer home-help hours provided than in 2008. Health promotion and prevention • Between 2005 and 2010, there was no designated budget for public health and many health promotion staff were redeployed to primary care and other services. The public health services that exist are very narrow, with a strong focus on immunization and some lifestyle-related initiatives. Public health and health promotion staff were categorized as population health staff and have seen a 20% reduction in numbers from 544 (March 2009) to 434 (November 2012). Plans for a new public health directorate within the HSE have been announced but no details are available as to its role or the extent of its resources.
- Page 392 and 393: Country profiles of health system r
- Page 394 and 395: Czech Republic Tomáš Roubal and J
- Page 396 and 397: Country profiles of health system r
- Page 398 and 399: Country profiles of health system r
- Page 400 and 401: Country profiles of health system r
- Page 402 and 403: Country profiles of health system r
- Page 404 and 405: Estonia Triin Habicht and Mall Lein
- Page 406 and 407: Country profiles of health system r
- Page 408 and 409: Finland Jan Klavus and Lauri Vuoren
- Page 410 and 411: Country profiles of health system r
- Page 412 and 413: France Karine Chevreul, Karen Berg
- Page 414 and 415: Country profiles of health system r
- Page 416 and 417: Country profiles of health system r
- Page 418 and 419: Country profiles of health system r
- Page 420 and 421: Germany Klaus-Dirk Henke and Wilm Q
- Page 422 and 423: Country profiles of health system r
- Page 424 and 425: Country profiles of health system r
- Page 426 and 427: Country profiles of health system r
- Page 428 and 429: Country profiles of health system r
- Page 430 and 431: Country profiles of health system r
- Page 432 and 433: Country profiles of health system r
- Page 434 and 435: Iceland Sigrún Gunnarsdóttir and
- Page 436 and 437: Country profiles of health system r
- Page 438 and 439: Ireland Anne Nolan and Steve Thomas
- Page 440 and 441: Country profiles of health system r
- Page 444 and 445: Israel Bruce Rosen and Amir Shmueli
- Page 446 and 447: Country profiles of health system r
- Page 448 and 449: Country profiles of health system r
- Page 450 and 451: Country profiles of health system r
- Page 452 and 453: Kazakhstan Ninel Kadyrova and Tata
- Page 454 and 455: Country profiles of health system r
- Page 456 and 457: Country profiles of health system r
- Page 458 and 459: Latvia Uldis Mitenbergs and Maris T
- Page 460 and 461: Country profiles of health system r
- Page 462 and 463: Country profiles of health system r
- Page 464 and 465: Country profiles of health system r
- Page 466 and 467: Country profiles of health system r
- Page 468 and 469: Country profiles of health system r
- Page 470 and 471: Malta Natasha Azzopardi Muscat Econ
- Page 472 and 473: Country profiles of health system r
- Page 474 and 475: Country profiles of health system r
- Page 476 and 477: Country profiles of health system r
- Page 478 and 479: Montenegro Ratka Knežević Economi
- Page 480 and 481: Country profiles of health system r
- Page 482 and 483: Country profiles of health system r
- Page 484 and 485: Country profiles of health system r
- Page 486 and 487: Norway Anne Karin Lindahl and Jon M
- Page 488 and 489: Country profiles of health system r
- Page 490 and 491: Country profiles of health system r
Country profiles of <strong>health</strong> system responses to the <strong>crisis</strong> | Irel<strong>and</strong><br />
409<br />
Payment to providers<br />
• From 2008, annual fee to GPs who treat medical card holders reduced.<br />
• From 2009, reduction of 8% on all professional fees <strong>and</strong> cut to pharmacy<br />
fees of 24–34%. Further cuts in fees of 5% for <strong>health</strong> professionals were<br />
introduced in 2010 <strong>and</strong> 2011. In 2013 budget, professional fees for<br />
<strong>health</strong> services providers were to be further reduced. It is estimated that<br />
pay-related savings will reach €308 million in 2013.<br />
Overhead costs: restructuring the Ministry of Health <strong>and</strong> purchasing agencies<br />
• HSE commitment in 2009 to reduce administrative, management <strong>and</strong><br />
advertising costs by at least 3%.<br />
• Cuts in administrative spending introduced in 2010 budget, including<br />
reducing HSE staff by 6000 (€300 million) plus additional efficiencies in<br />
the HSE (€90 million).<br />
• Cuts in administration (€43 million) proposed in 2011 budget.<br />
• Administrative savings in the Department of Health were to total<br />
€20 million.<br />
Provider infrastructure <strong>and</strong> capital investment<br />
• Measures to provide more services with fewer resources: hospital day<br />
care increased by 5% in the first six months of 2009 relative to 2008<br />
<strong>and</strong> above the 2009 target; outpatient appointments increased by 3%<br />
between the first six months of 2008 <strong>and</strong> 2009 <strong>and</strong> the number of new<br />
outpatient attendances increased by 6% in the same period; hospital<br />
capacity reduced by 519 beds between January <strong>and</strong> July 2009.<br />
• The approval (subject to planning permission) for a new National<br />
Children's Hospital at the expected cost of €500 million was announced<br />
in November 2012. It is planned to be completed by 2018 (at the latest)<br />
<strong>and</strong> will merge the three existing children's hospitals.<br />
Priority setting or protocols to change access to treatments, coordination<br />
of care <strong>and</strong> patterns of use<br />
• Since 2008–2009, 31 clinical care programmes have been in place that<br />
utilize a model of care devised for improving the quality of cancer care;<br />
this model is now being applied to all diseases <strong>and</strong> conditions in all <strong>health</strong><br />
care settings. Many of the efficiencies gained in 2012 are attributed to<br />
service improvements brought about by the clinical care programmes.<br />
Waiting times<br />
• Between January <strong>and</strong> September 2012, the number of people waiting<br />
on trolleys in emergency departments fell by 24%, the number of adults