Proposed ambulatory elective hospital centres ‘not everything required by Cork or Galway’

Feedback from many consultants positively disposed to Sláintecare contract

The development of a four to five year multi-annual plan under the Sláintecare strategy and action plan ‘to get rid of waiting lists’ is advanced and about to be submitted to the Minister for Health the latest Oireachtas Health Committee meeting has heard (June 9).

This would be the barometer of the success of Sláintecare, Laura Magahy, Deputy Secretary, Sláintecare Implementation Office told Committee members.

During the online meeting, she said a lot of work had been completed over the last four months on the complex waiting list plan. Waiting time targets were 12 weeks for inpatients; 10 weeks for outpatients and 10 days for diagnostics.

They were working with colleagues in the National Treatment Purchase Fund (NTPF) and the Health Service Executive (HSE), and would be submitting the plan for waiting lists in the health and community sectors and not just hospitals, to the Minister for Health to bring it to Government, to see if the Government would commit to a multi annual plan to get rid of the waiting lists “once and for all”.

“We need a longer term view to drive these down,” she added.

During an update to the Committee on the implementation of the Sláintecare action plan 2021-2023, she said the goal was to separate private and public not to eliminate private care. Under the proposed reforms, the new Sláintecare Consultant Contract had been issued to the consultant representative bodies; there was room for movement on the non Government policy decision areas.

They were hoping for substantial engagement on the new Slaintecare contract from the doctors’ representative bodies over the next short period.

“There is an awful lot to discuss within. There are two fundamental things the Government did decide on which is, one, not to have any private practice off site and the second was the salary levels. But there’s plenty of other things that can be discussed and engaged on in a meaningful way.

“We have had feedback from many consultants who are positively disposed to the contract to say this will give more security; it’s a very comparative rate internationally and there’s good supports going with the actual basic salary,” added Magahy.

A number of members, Deputy Colm Burke, Social Democrat Co-Leader Deputy Róisín Shortall and Senator Seán Kyne sought clarification on details in relation to the proposed ambulatory elective centres, particularly in relation to inpatient or overnight beds.

Magahy told Committee members that the elective centres had been designated as ambulatory day surgery hospitals in the National Development Plan 2018-2027, and they had devised a national model for ambulatory elective hospitals that would treat up to 400 different procedures. She confirmed inpatient or overnight beds were not envisaged for the centres.

There were nine theatres proposed at present for Cork, eight in Galway and 21 in Dublin.

They recognised the need for additional investment in both Cork and Galway and there were requirements around the country for more inpatient beds.

The first thing they did was to make sure the sites being chosen were big enough to accommodate the wider proposals for Cork and Galway so that the proposal offered by Cork and Galway could progress in tandem, if funding were there, with the elective surgery proposal.

The issue was that the larger capacity requirements that Galway and Cork had were outside of the day surgery proposal. They needed to be considered as part of the National Development Plan (NDP) and it was not that one model was wrong and one model was right.

The meeting heard there was recognition that what was being proposed in elective day surgery was additional to what was there at the moment; that would create capacity, it would free up capacity in existing hospital theatres and day surgery beds.

“We understand that is not everything required by Cork or Galway or other areas around the country. We have had substantial engagement with South/South West [hospital group] as recently as last Friday.

“When we went out looking for sites, we made sure we were looking for a site that was big enough to accommodate both the elective hospital ambulatory requirements and the inpatient and overnight stays, which I know is the wider ambition of the South/South West group.”

She said it was a similar situation in Galway where they had a wider plan and they were meeting weekly with the Saolta group to see how the two proposals might be aligned and progressed together.

Deputy Shortall asked for a timescale on Sláintecare implementation. In summary, Magahy said, enabled by the budget, by the end of three years they would have the multi annual plan to reduce the waiting lists substantially implemented; construction on the new elective centres begun; the Sláintecare consultant contract rolled out; the six new Regional Health Areas created and mainstreamed access for patients direct diagnostics.

In that period, they will have hired 7,000 new community based staff; delivered 31 new primary care centres; invested in 32 new community specialist hubs, 57 healthy communities; and established the Community Healthcare Networks.

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