Strengthening the primary care system must be the starting point of a long-term blueprint to overhaul the country’s “unsustainable” health service, according to a major reform document.
The Department of Health report, Better Health, Improving Healthcare, says significant changes are needed if the health service is to deal effectively with an ageing population and rising burden of chronic disease.
The report, due to be published later this week, comes as Minister for Health Simon Harris prepares plans for a cross-party committee which will help draw up a 10-year blueprint for the health service. The initiative will be based on consultation with all political parties and stakeholders, including frontline staff.
It is understood Mr Harris is to seek Cabinet approval shortly to establish such a grouping. The advisory report warns the rising burden of chronic disease is not simply a future concern, but one which is being presently faced by the health services.
Studies estimate that up to 250,000 people in Ireland are living with diagnosed cardiovascular disease and up to 440,000 suffer from chronic obstructive pulmonary disease, many of whom are undiagnosed. The aging population is expected to lead to a sharp increase in these types of conditions.
Cancer cases
Projections suggest that between 2011 and 2021, the population aged 65 and over will increase by almost 40 per cent. This is likely to cost the health services some €200 million a year. The number of cancer cases is estimated to increase by 70 per cent among women and 83 per cent among men over the next 25 years.
The report is understood to say the roots of the hospital trolley crisis can be traced back to an outdated model of care, struggling to cope with new types and levels of demand.
Episodic treatment
The present system, it notes, has largely been built up to provide episodic treatment. Yet, some three-quarters of health service activity relates to chronic disease, illnesses which require ongoing care and substantial co-ordination.
Significantly, it estimates that about 80 per cent of heart disease, as well as 40 per cent of cancer, can be prevented if major risk factors are eliminated. These include tobacco and alcohol use, physical inactivity, poor diet and obesity.
Among the key proposals in the report include the development of comprehensive primary care services as the most fundamental building block of a new, more integrated model of health and social care.
It is understood to say that primary care is fragmented and insufficiently developed to meet growing needs in an equitable manner.
A key focus of this work should be how to deliver better management of chronic disease and frail elderly patients within primary care.
In addition, a revised GP contract should be negotiated that supports more comprehensive primary care services, chronic disease management and multi-disciplinary working. Primary care centres need to be equipped to deal with a much wider range of services which traditionally take place in acute hospitals.
