Thursday 22 November 2018

Early death still 'a major health issue'


Without changes in our lifestyle, there will be many avoidable deaths, says National Health Strategy

PREMATURE death remains a "major public health issue" in Ireland today, the Government's new National Health Strategy will say. Many deaths caused by cancer, circulatory diseases and injury are preventable, it will state.

If the trends in smoking, alcohol consumption, diet and lifestyle are not reversed, there will continue to be "many avoidable deaths."

The long-awaited strategy, the summary of which has been leaked to the Sunday Independent, will be unveiled by the Government tomorrow.

In a chapter called 'Understanding our health', the strategy reveals that life expectancy is:

* increasing in Ireland, but not as fast as in Europe;

* poorer for males than females;

* only showing "modest improvement" for older people.

The strategy also says that the gap in life expectancy between Ireland and Europe is widening.

It discusses the relationship between health and socio-economic status in Ireland. "This is an important consideration in addressing the overall health of the population." It adds that effective action in relation to this issue will "require an inter-sectoral approach".

The strategy states that there is "increasing evidence" that the system does not have the capacity to meet demand.

Additional investment across the system will be necessary. Furthermore, a "reorientation" of existing services is proposed.

The health system also needs to be "reformed and developed". Frameworks for change include strengthening primary care, reforming acute hospitals, funding, developing human resources, organisational reform and developing health information.

Primary care, it says, must become the "central focus" of the health system. To do this, a "new comprehensive model of primary care, based on close teamwork between health professionals", is proposed.

There will be "close co-ordination and integration" between primary and hospital services and a task force will be set up to oversee the phased implementation of the model over the lifetime of the Health Strategy.

The present centrally funded tax-based system of funding, complemented by private health insurance, will be retained; capital and revenue funding will be increased; and a "clear evidence-based methodology" for funding, linked to "strategic objectives", will create "positive incentives" to improve access and increase levels of services.

In relation to human resources, the strategy says that the Government has asked the National Centre for Partnership and Performance to work closely with government departments, state agencies, employees, unions and staff to "promote organisation change in a way that will improve the delivery of services".

A framework for organisation reform is "aimed at providing a responsive, adaptable health system which meets the needs of the population effectively and at affordable cost".

It states that it is important to develop a "single integrated system" rather than one which varies between the approaches taken in individual health board areas. This requires more co-ordination between health boards, particularly in planning and service delivery.

On organisation reform, the strategy states that the Department of Health and Children will be restructured; health boards will focus on a programme of change management; an Independent Health and Information Quality Authority will be set up; a comprehensive independent audit of the structures and functions of the health system will take place to determine the scope for rationalisation of bodies and to improve governance.

The approach to the implementation of the health strategy will make explicit the responsibilities and tasks of relevant sectors, organisations and key individuals.

It will also have "clear political leadership"; reflect the "valid expectations" of users, voluntary and community interests and staff to be involved in reshaping the health system and allow for "responsive innovation, locally clarified priorities and need".

In addition to implementation, under the new strategy, a system to monitor progress and systematically evaluate the quality and effectiveness of services being delivered will be put in place.

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