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The impact of Government health policy on older people

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

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The impact of Government health policy on older people

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  1. The impact of Government health policy on older people 23 October 2013 Respond! National Conference Dr Sara Burke

  2. 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

  3. 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

  4. 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

  5. Numbers covered by medical cards, drug payment scheme, long term illness and high tech drug scheme 2005-2011

  6. Cost of each scheme, 2005 to 2012

  7. 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

  8. % change, budget, staff, inpatient, day cases, ED attendances, OPD 2005 – 2012/3

  9. 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….

  10. Numbers waiting for elective hospital care 2008 to 2013

  11. 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?

  12. 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

  13. 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

  14. 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

  15. Thank you for listening www.resilience4health.com www.saraburke.com

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