Opening Statement by Mr

Joint Committee on Health & Children

22nd March 2012

Opening Statement

by Mr. Cathal Magee

Chief Executive Officer Health Service Executive

1 Good morning Chairman and members of the Committee.

Thank you for the invitation to attend the Committee meeting today.

I am joined by a number of my colleagues: Ms. Laverne McGuinness, National Director, Integrated Services Dr. Barry White, National Director Clinical, Strategy and Programmes Mr. Liam Woods, National Director of Finance

Also in attendance and available to the Committee are Dr. Philip Crowley, National Director of Quality & Patient Safety and Mr. Barry O’Brien, National Director of HR.

The Committee has requested information and replies on a number of specific issues prior to this meeting. You will have received a written response to these issues from the HSE and the Department of Health. My opening remarks will be a brief update on two key matters recently reviewed by the Committee.

Medical Cards When you, Chairman, and members visted the PCRS in Finglas on 2nd March you were advised that a backlog of applications had developed in 2011. A comprehensive Action Plan has been developed and put in place to deal with this issue. At the 26th January 2012 the backlog stood at 57,962 and this was reduced to 31,456, at the 2nd March 2012. Figures for the 14th March show the backlog has been reduced to 20,967. PCRS are on track to clear the backlog as planned by end of April.

Under the plan, a Medical Card will remain valid, irrespective of the expiry date shown on the card, once the Medical Card holder is genuinely engaging with the

2 HSE review process. Eligibility for services can be confirmed by any Doctor or Pharmacist or by the Medical Card holder online at www.medicalcard.ie or through the GP practice system or in any Local health office or through the helpline at 1890-252-919.

A range of initiatives have also been implemented under the plan to address many of the issues which have arisen in the initial months of centralisation.

 A key change has been the introduction of self-assessment reviews for card holders under 70 years of age

 Extension of card expiry dates from two to three years in most cases

 The provision of system facilities to GPs to allow temporary extension of card eligibility for expired cards and to add new babies to existing cards

In cases where a medical card is required in emergency circumstances, such as for terminal illenss or for a serious medical issue, an Emergency Medical Card may be issued. Such an application can be initiated through the Local Health office. Details of this proceedure are available to all GP’s and Social Workers. Such cards will be issued within 24 hours.

As before , no means test applies to an application by a terminally ill patient and all terminally ill patients will be provided with a medical card number for a period of six months once their medical condition is verified by a GP or a consultant.

In other emergency cases (e.g. where a person in need of urgent medical attention cannot afford to pay for it etc), the HSE issues all Emergency Medical Cards on the

3 presumption that the patient is eligible for a medical card (i.e. that they satisfy the eligibility criteria in terms of a means test or on the basis of undue hardship), and that the applicant will follow up with a full application within a number of weeks of receiving the Emergency Medical Card. As result, Emergency Medical Cards are issued to a named individual, with a limited eligibility period of six months.

The HSE has also commenced a review of Medical Card operations with support from PWC, to develop medium and longer term improvements. The report and implementation plan will be completed shortly and it will be forwarded to the Joint Committee when it is available.

End of Grace Period The total headcount of staff members, who have retired under the ‘grace period’ retirement scheme as of the 9th March 2012 is 4,515.

Staff Category Total General Support Staff 492 Health & Social Care Professionals 424 Management/Admin 411 Medical/Dental 174 Nursing 2104 Other Patient & Client Care 873 To be determined 37 TOTAL 4515

Planning to manage the impact of the ‘grace period’ has been ongoing at national, regional and local level. The HSE’s overarching aim in this process has been to protect critical frontline essential services and there are a range of national measures in place to reduce the impact of the retirements on frontline services. These include using the provisions of the Public Service Agreement (Croke Park) and delivering greater productivity through the National Clinical Programmes.

4 Where critical gaps in services cannot be filled through redeployment, reconfiguration or the reorganisation of services, €16 million has been allocated for the targeted recruitment and filling of critical roles aimed at minimising the impact of early retirements on frontline services. 288 of these replacements will be in the acute hospital services and 244 in community services. This figure for community service replacements does not include the additional investment and posts identified in the HSE’s 2012 National Service Plan for Mental Health (414 posts) and Primary Care investment of €20 million.

The Regional Directors for Operations, Hospital CEO’s and Area Managers have provided written assurance that the risks associated with the ‘Grace Period’ retirements Scheme have been identified and that the appropriate measures to minimise impact on frontline services are being managed appropriately. The regional and service level contingency plans continue to be monitored as part of the transition process.

This concludes my opening statement. Thank you.