Policy and International Affairs
Overview
In June 2013 the Policy and International Affairs Unit of the IMO were combined to manage policy issues more effectively at both National and European level.
As the representative body for the medical profession, the IMO in its mission statement is committed to the development of a caring, efficient and effective Health Service and thus a key activity of the IMO is advocacy. The IMO develops policy on a wide range of Health Service and Societal issues and aims to influence Government proposals in a constructive and practical way. The development of IMO policy is the remit of the Council. Policy is also developed on foot of IMO AGM Motions and in conjunction with the IMO membership.
International Policy is the remit of the IMO International Affairs Committee. The IMO works across a number of European and International medical organisations to represent the interests of Irish doctors on medical education and training issues, along with professional, ethical and socio-medical affairs. By working with other National Medical Associations, the IMO can contribute effectively to debate and influence policy through collaborative international structures.
For more information contact:
Vanessa Hetherington
Assistant Director, Policy and International Affairs
Irish Medical Organisation
10 Fitzwilliam Place, Dublin 2
Tel: +353 (0)1 6767273
Email: vhetherington@imo.ie
2020 Vision For Health
The Reality of Our Health Services Today
- Over the period 2009 to 2014, €4 billion was taken out of the HSE budget, requiring a supplementary budget of €510 million in 2014.
- Staffing levels in the HSE have fallen by 12.9%, or 14,418 whole time equivalent employees, since 2007.
- The number of acute hospital beds has fallen by 13% or 1,631 acute beds since 2007.
- Hospitals are operating at 92.6% capacity and emergency department overcrowding and waiting times for outpatient appointments have reached unacceptable levels.
- General practitioners are treating an additional half a million Medical Card and GP Visit Card holders, while struggling with funding cuts of €160 million.
- Few primary care teams are fully operational and waiting lists apply for all allied health and social care professionals in primary care.
- The elderly population over 70 years of age has increased by 20% between 2006 and 2014, without an increase in required services.
- The number of home help hours has fallen by 18.5%, or 2.3 million hours, between 2008 and 2014.
- The number of long-stay beds has decreased by 9%, or 2,186, between 2008 and 2013.
- The Irish health services are not an employer of choice for Irish-trained doctors and the country is experiencing unprecedented levels of emigration amongst the medical profession.
Universal Healthcare NOT Universal Health Insurance
The IMO is committed to a Universal Healthcare system that aims to secure access to adequate, quality healthcare for all, when it is needed, and at an affordable cost.
Universal Health Insurance (UHI) is a funding model that will introduce a market model of healthcare where financial interests of private health insurers and corporate healthcare providers will take priority over patient care.
A funding model that relies on mandatory private health insurance is fundamentally flawed, and cannot deliver on affordability, equity of access, choice, timely access to care, quality of care, or value for money.
The IMO believes that:
- all patients have should timely and equitable access to appropriate and affordable preventative, curative, and rehabilitative healthcare;
- we need to review and examine other funding models, such as taxation and social insurance models;
- universal GP services are the cornerstone of any Universal Healthcare system. GP services that are free at the point of access must be extended on the basis of income and structured chronic disease programmes introduced; and
- until capacity in acute hospitals is addressed, Universal Healthcare implementation will not be capable of delivery.
IMO Position Paper on the Market Model of Healthcare - Caveat Emptor
IMO Submission to the DoH's Consultation on the White Paper on Universal Health Insurance
Financial, Capacity, and Manpower Planning
Health services are complex and require detailed, long-term planning to run efficiently and to best serve the needs of patients. The IMO believes health requires a five-year strategic plan with ring-fenced resources to implement that plan.
In order to develop a credible plan for our services we need:
- a comprehensive assessment and costing of the level of service and capacity required across the health system, including acute hospital care, GP care, and ancillary professional services in primary care, long-term, and community services, which considers the demographic shifts expected in the future; and
- a commitment to ring-fence the funding required to meet the service, capacity, and manpower requirements identified, as the current system of funding crisis initiatives is not sustainable or viable and such ring-fenced finding will commit to ending the system whereby hospitals routinely engage in rolling theatre closures, ward closures, and cancelling of elective surgery to meet budget targets.
Patient Safety and Quality of Care
Patient safety and quality of care are of paramount importance to doctors in Ireland. You can’t ensure quality of care without engaging with and supporting staff.
IMO members have been increasingly concerned about the effects of successive budget cuts and reduced staffing levels on patient safety and quality of care.
It is imperative that:
- all clinical services operate with sufficient minimum financial and manpower resources necessary to provide safe, quality, and evidence-based care;
- all healthcare facilities are adequately resourced to meet and exceed HIQA standards of care, as introducing standards without supporting resources required for their implementation will result in failure;
- Government invest in information and communication technology, particularly electronic health records, to improve patient safety and eliminate duplication across services; and
- Government encourage and support innovative patient safety initiatives and reform medical negligence system.
IMO Submission to the European Commission's Consultation on Patient Safety and Quality of Care
Putting Mental Health on a Par with Physical Health
Mental health disorders affect one in four adults in Ireland and are the leading cause of disability worldwide, but less than 50% of people receive professional help and even less receive appropriate care.
Stigma and discrimination continues to pose a major barrier to help seeking. Wholly inadequate resources are allocated to mental health services and both financial and manpower resources are unevenly distributed with no relationship between population size or socio-economic need.
In order to move to a situation whereby mental health services operate effectively we need:
- investment in evidence-based programmes to reduce stigma and raise awareness about mental health issues and suicide prevention;
- access to publicly funded counselling and psychotherapy services upon GP referral that can be accessed without lengthy delays;
- investment and development of community and specialist mental health teams; and
- the transparent allocation of resources based on population need.
IMO Position Paper on Addiction and Dependency
IMO Submission to the Mental Health Commission's Consultation on its Strategic Plan for 2016-2018
Health in All-Policies
Significant levels of health inequalities exist in Ireland. A wide range of factors such as poverty, inequality, social exclusion, employment, income, education, housing conditions, transport, access to healthcare, lifestyle, and stress all impact on an individual’s health and well-being.
Improving the health of all our citizens will reap long-term benefits for our country by ensuring a healthier and more productive workforce with less need for expensive health interventions and social supports.
Ireland should commit to, and resource, the goals of Healthy Ireland – A Framework for Improved Health and Wellbeing 2013-2025 and:
- develop a detailed implementation plan for Health Ireland, with appropriate multi-annual ring-fenced funding to support actions and initiatives; and
- ensure that all policy decisions across all Government departments are subject to a health impact assessment.
A Healthcare System that Protects the Doctor-Patient Relationship
The doctor-patient relationship is one that is based on trust. Patients trust in their doctor’s professionalism, and that he or she will act in his or her patients’ best interests, without interference from commercial or political interests.
To ensure that our healthcare system protects the doctor-patient relationship, public policy should:
- exhibit respect for clinical autonomy and ensure the doctor-patient relationship is free from interference from commercial or political interests;
- foster a culture of trust in the medical profession;
- ensure policy decisions affecting the delivery of healthcare in Ireland are evidence based and made in partnership with the medical profession; and
- ensure all policy decisions are equally supported by required resources.
Current European and International Issues
Development of Healthcare Standards at CEN – Comité Européen de Normalisation / European Committee for Standardisation
The Irish Medical Organisation (IMO) and all European and International medical professional bodies are concerned and opposed to the developments of healthcare standards at CEN Comité Européen de Normalisation / European Committee for Standardisation.
- The medical profession maintain that standards for healthcare services should be developed, implemented and monitored by the relevant competent authorities in consultation with the medical profession so as to ensure the highest standards of care.
- There is an urgent need to regulate for the provision of aesthetic surgery and non-surgery services at National level in many EU member states including Ireland. However the IMO and all European Medical Organisations believe that the development of standards by CEN, the European industrial standards body, is a poor substitution for adequate national regulation.
- There is a general concern from the medical profession in regarding the introduction of such specific standards to medical procedures. Not only is education and training far from being harmonized throughout the EU medical training, resources, equipment and even specialties themselves differ significantly around the EU. Currently, the disparities between Member State’s medical education and training, along with resources and facilities are too great to provide such universal standards that have been developed by CEN and not by the profession itself. There is a risk that European Standards are set at the lowest common denominator undermining the efforts of national bodies to ensure the highest quality of care.
- Healthcare standards must be developed by national competent authorities in consultation with the medical profession and take into account medical training, resources and the organisation of health care services in each member state.
- There is support at EU level for the development of European Standards for Healthcare as stated in the Council of the European Union issued Recommendation 2009/C151/01 on Patient Safety. However a more appropriate forum for the development of health care standards must be found at European level that promotes the high quality care and patient safety across Europe and ensures that standards are developed by competent authorities in consultation with the medical profession.