Transcript Slide 1

The impact of Government
health policy on older people
23 October 2013
Respond! National Conference
Dr Sara Burke
Outline
• Key components of government health
policy
• Impact of austerity measures on health
system
• Dr Steve Thomas, Dr Sarah Barry, TCD
www.resilience4health.com
• Critique of progress to date
Programme for Government 2011-2016
• This government is the first in the history of the
State that is committed to developing a single-tier
health service which guarantees access to medical
care based on need, not income
• Universal Health Insurance designed according to
the European principle of social solidarity
• No discrimination between patients on the grounds
of income or insurance status
• Free GP care for all by 2015
Programme for Government 2011-2-16
• Investment in more and better care for older people in
the community and in residential settings will be a
priority of this Government
• Additional funding will be provided each year for the care
of older people
• This funding will go to more residential places, more
home care packages and the delivery of more home help
and other professional community care services
• Bring down price of drugs
4,000,000
3,500,000
3,000,000
2,500,000
2,000,000
1,500,000
1,000,000
500,000
0
2005
2006
2007
2008
GMS
DPS
LTI
2009
2010
2011
HTD
Numbers covered by medical cards, drug payment scheme, long term illness
and high tech drug scheme 2005-2011
2,500,000,000
2,000,000,000
€
1,500,000,000
1,000,000,000
500,000,000
0
2005
2006
2007
2008
GMS
DPS
2009
LTI
2010
HTD
Cost of each scheme, 2005 to 2012
2011
2012
Impact of austerity
• Highest ever numbers of medical card holders,
• Yet slow down in new medical cards holders
• Jan – July 2012 – 127,000 new: 2013 - 15,000 new
• Decline in discretionary cards
• Budget 2014 predicated on at least 150,000 fewer medical
cards including 35,000 over 70 year olds
• Fewer in Drug Payment Scheme
• Increased charges evident in drug charges
• From €120 - €144 prescription drugs payment for 60% of pop
• From 50 cent to €2.50 for medical cards holders
% change, budget, staff, inpatient, day cases, ED
attendances, OPD 2005 – 2012/3
Impact of austerity in 2013
• Staffing now 11,320 below Sept 2007 level
• Not meeting troika requirements
• Meant to have 2,480 fewer staff by Dec 13
•
•
•
•
•
1,000 fewer hospital beds, 781 delayed discharges
Emergency admission 3% higher 2013 v 2012
Decline in inpatient cases 2013 v 2012
Pushing same day admission & shorter ALOS
Yet, 2.5 million fewer home help hours….
60,000
50,000
40,000
30,000
20,000
10,000
0
2008
2009
2010
0 to 3
3 to 6
2011
6 to 12
12 +
Aug-12
24 +
Numbers waiting for elective hospital care 2008 to 2013
Aug-13
Impact of austerity on health system
• Some improvements up to August 2012
• Reversal of progress made
• More people waiting longer, except longest
• Aug 2013, 1000 waiting 1 yr +, 4,792 waiting 9 months + but
overall more people waiting
• Aug 2013: 374,104 outpatients waiting, 2,236 4 yrs+, 6,008 3
yrs+, 20,501, 2 yrs+, 55,422 1 yr+
• Target by Dec 2013 no one 1yr+ OPD, 8 mths elective
• System reaching breaking point?
Programme for Government
commitments to older people?
• This government is the first in the history of the
State that is committed to developing a single-tier
health service which guarantees access to medical
care based on need, not income
• Universal Health Insurance designed according to
the European principle of social solidarity
• No discrimination between patients on the
grounds of income or insurance status
• Free GP care for all by 2015
Programme for Government
commitments to older people?
• Investment in more and better care for older people in
the community and in residential settings will be a
priority of this Government
• Additional funding will be provided each year for the
care of older people
• This funding will go to more residential places, more
home care packages and the delivery of more home
help and other professional community care services
• Bring down price of drugs
The impact of Government health
policy on older people
• Health policy driven by austerity
• Smaller budget, fewer staff, growing demand
– Driving ‘efficiencies’
– Now having to do less with less
• Transferring cost of care on to people eg drugs
• Impact of Budget 2014
– 34% over 70s have both medical cards & PHI
• Mission impossible with €1 billion less
Thank you for listening
www.resilience4health.com
www.saraburke.com