Reflecting on my Time as Minister of State at the Department of Health
I have recently been appointed as Minister for Communications, Energy and Natural Resources. I am looking forward immensely to tackling the work at hand at the Department and to co-operating closely with my new Cabinet colleagues.
I am also energised by the number of challenges and opportunities facing the Labour Party, and I hope to play an important part in helping to face those issues head on.
With the assumption of my new role and as the Dáil is now in recess, I thought I might provide a summary of my achievements in the past 21 months as a Minister of State at the Department of Health, which I have posted below for your information.
As Minister of State in the Department of Health I delivered on Labour’s commitment to legislate for the X case. I secured government agreement on the alcohol strategy – the first time ever in this country that alcohol misuse is being addressed in public health legislation. I advanced our long-standing policy of universal access to primary care. Against what many people said were impossible odds, I recently negotiated a framework agreement with the IMO that will facilitate progress on this critical public health measure, something that we have been arguing for years, and that we are now making a reality. I am proud to have steered reference pricing legislation through the Houses of the Oireachtas as it allows for cheaper, generic drugs to be made available to patients. I also worked to renew the National Drugs Strategy and Oral Health Policy during my time in office.
Free GP Care for Children Aged Under Six
The Dáil and Seanad approved The Health (General Practitioner Service) Bill 2014. This is the legislative basis for the new universal GP service and provides an entitlement for all children aged under six years to a GP service without fees. It is the first stage of the Government’s commitment to introducing, on a phased basis, a universal GP service without fees within its term of office, as set out in the Programme for Government.
The Bill passed all stages before the summer recess. It is intended that it will be implemented in the Autumn.
I am immensely proud of this significant achievement in advancing an historic public health initiative to deliver GP services to the population free at the point of access.
The Government provided new, additional funding of €37 million to meet the cost of free GP care for children aged under six.
Brokering a Framework Agreement with the IMO
In May, I made significant progress with the Irish Medical Organisation (IMO), brokering a framework agreement between the IMO and the Department of Health which sets out a process for engagement concerning publicly funded contracts involving GPs.
I am pleased to report that meaningful engagement is now taking place between the Department of Health, the HSE and the IMO. I believe that this framework agreement will pave the way for open and constructive discussions in the future regarding primary care which will lead to an enhanced GP service in communities across Ireland.
Building Primary Care Centres
Primary care infrastructure is being delivered using three mechanisms – direct build, leasing initiative and a public private partnership initiative announced in the July 2012 infrastructure stimulus package. The development of primary care centres, through a combination of public and private investment, will facilitate the delivery of multi-disciplinary primary care and represents a tangible re-focussing of the health service towards care in the most appropriate and lowest cost setting.
37 Primary Care Centres have opened since March 2011 and a further 20 new Primary Care Centres are due to open in 2014 or Quarter 1 2015. I was delighted to officially open 12 Primary Care Centres during my period of office as Minister of State at the Department of Health.
Filling Front Line Primary Care Posts
In 2013, Primary Care funding of €20 million was provided to support the recruitment of 264.5 prioritised front-line primary care team posts, based on the analysis carried out by the HSE in identifying areas of deprivation and need:
- 72 Public Health Nurses;
- 40.5 Registered General Nurses;
- 52.5 Occupational Therapists;
- 47.5 Physiotherapists; and
- 52 Speech & Language Therapists.
The Public Health (Alcohol) Bill
I presented to Government the General Scheme of a Public Health (Alcohol) Bill, which includes minimum unit pricing, the regulation of marketing, advertising and sports sponsorship of alcohol and the health labelling of alcohol products.
I secured government-approval for a package of measures, which for the first time will comprehensively address our societal misuse of alcohol.
This was an important breakthrough at Cabinet as it represents the first time alcohol misuse has been addressed as a public health issue. The package of measures to be implemented is the result of intensive discussions across Government departments and is based on the 2012 Substance Misuse Report.
The Report correctly identified that the misuse of alcohol could only be addressed through a range of complementary measures rather than one particular mechanism or procedure. I am greatly appreciative of the time and energy my government colleagues expended in advancing this major public health initiative. I look forward to the progression of this legislation in the coming months.
The Protection of Life Legislation
Twenty-one years after the X case, the enactment of the Protection of Life legislation is the achievement I am most proud of during my time as Minister of State at the Department of Health. I led detailed negotiations with Fine Gael on the text and piloted the new law through the Oireachtas.
The Protection of Life legislation gave expression in statute to a constitutional right, and in doing so, provided a procedure through which that right may be exercised.
This issue has always been one that relates principally to women’s lives. I believe strongly that it is also an issue of women’s rights. Many women – and men – are disappointed that more could not have been done in this legislation. But we must honestly accept that what was enacted by the Oireachtas is no more, and no less than what the people have provided for in their Constitution, as interpreted by the Supreme Court some 21 years ago in the X case.
For any further changes to occur will require an amendment to the Constitution, which can only be done by the people in a referendum. I believe there is a strong case for such a referendum.
Generic Drugs: Patients and Taxpayers Benefiting from Reduced Costs
The Health (Pricing and Supply of Medical Goods) Act 2013 which was commenced on 24th June 2013 introduced a system of generic substitution and reference pricing for prescribed drugs and medicines. I guided this critical piece of legislation through the Oireachtas.
Previously, when a specific brand of medicine was prescribed for a patient, a pharmacist could only supply that particular brand, even when less expensive generic versions of the same medicine were available. The Act now permits pharmacists to substitute medicines prescribed, providing that they have been designated as safely interchangeable by the Health Products Regulatory Authority.
The introduction of reference pricing represents a major first step in ensuring lower prices are paid for medicines in Ireland with 70% less now being paid for atorvastatin products, 56% less for esomeprazole products and 40% less for rosuvastatin products for example. Reference pricing is expected to save in the region of €50m in 2014 – with more savings to follow in the coming years.
Generic substitution is being introduced incrementally with the Health Products Regulatory Authority prioritising those medicines which will achieve the greatest savings for patients and the State. The Authority is in the process of reviewing an initial 40 active substances. To date the HPRA has completed the assessment of 25 active substances.
Medicinal Cannabis to be made Legal and Available for Patients
My last act as Minister of State for Primary Care was to sign regulations to enable authorised cannabis-based medicinal products to be legally prescribed by medical practitioners and used by patients.
I’m glad that many of the matters that had inhibited the progress of this issue have now been resolved. Hopefully, with the legal impediments now removed, a cannabis-based medicinal product will soon be available to ease the symptoms of spasticity for people with multiple sclerosis where other conservative treatments have failed.
Renewing the National Drugs Strategy
Soon after taking up office I announced the conclusions of a review of the Drugs Task Forces undertaken by the Department of Health. That Review recommended a series of reforms to better equip the Drugs Task Forces in their response to the current pattern of substance misuse.
A new National Co-ordinating Committee was established to guide the work of the Drug and Alcohol Task Forces, and to ensure the ongoing implementation of the National Drugs Strategy. It held its inaugural meeting in January 2014.
Early in 2013, I had the opportunity to oversee the delivery of the 2012 Progress Report on the 2009-2016 National Drugs Strategy. As Minister of State I embarked on a programme of formal meetings with all of the key contributors to the National Drugs Strategy – to figure out how we can renew the implementation of the National Drugs Strategy. The bilateral meetings offered the chance to explore where relationships across agencies and departments, offices and services, could be deepened and strengthened.
In 2015, each Drugs and Alcohol Task Force will receive additional funding of €50,000 as part of the Dormant Accounts Action Plan 2014. This funding will support an integrated and evidence-based approach to prevention and education interventions aimed at tackling problem drug and alcohol misuse at a local level.
In 2014, we were able to increase the budget of the Dental Treatment Services Scheme from €63 million to €75 million. This funding is important for providing essential dental services to medical card patients.
A new oral health policy is being developed to support modernisation and change in the delivery of oral health services in line with the ‘Future Health’ framework for reform.
There are no plans to cease fluoridation. Nevertheless, the Department of Health keeps this policy under constant review. As part of this ongoing work, a review of evidence on the impact of water fluoridation at its current level on the health of the population and on the environment is being conducted by the Health Research Board on behalf of the Department.
The Department is also collaborating in a University College Cork-led research project, “Fluoride and Caring for Children’s Teeth” (FACCT). In addition, the pilot phase of a study on general and oral health findings in adults linked to the duration of exposure to fluoridated water as part of the Irish Longitudinal Study on Aging (TILDA) is underway.