1. The impact of Government health policy on older people 23 October 2013 Respond! National Conference Dr Sara Burke

2. Outline Key components of government health policy Impact of austerity measures on health system Dr Steve Thomas, Dr Sarah Barry, TCD www.resilience4health.com Critique of progress to date

3. Programme for Government 2011-2016 This government is the first in the history of the State that is committed to developing a single-tier health service which guarantees access to medical care based on need, not income Universal Health Insurance designed according to the European principle of social solidarity No discrimination between patients on the grounds of income or insurance status Free GP care for all by 2015

4. Programme for Government 2011-2-16 Investment in more and better care for older people in the community and in residential settings will be a priority of this Government Additional funding will be provided each year for the care of older people This funding will go to more residential places, more home care packages and the delivery of more home help and other professional community care services Bring down price of drugs

5. Numbers covered by medical cards, drug payment scheme, long term illness and high tech drug scheme 2005-2011

6. Cost of each scheme, 2005 to 2012

7. Impact of austerity Highest ever numbers of medical card holders, Yet slow down in new medical cards holders Jan – July 2012 – 127,000 new: 2013 - 15,000 new Decline in discretionary cards Budget 2014 predicated on at least 150,000 fewer medical cards including 35,000 over 70 year olds Fewer in Drug Payment Scheme Increased charges evident in drug charges From €120 - €144 prescription drugs payment for 60% of pop From 50 cent to €2.50 for medical cards holders

8. % change, budget, staff, inpatient, day cases, ED attendances, OPD 2005 – 2012/3

9. Impact of austerity in 2013 Staffing now 11,320 below Sept 2007 level Not meeting troika requirements Meant to have 2,480 fewer staff by Dec 13 1,000 fewer hospital beds, 781 delayed discharges Emergency admission 3% higher 2013 v 2012 Decline in inpatient cases 2013 v 2012 Pushing same day admission & shorter ALOS Yet, 2.5 million fewer home help hours….

10. Numbers waiting for elective hospital care 2008 to 2013

11. Impact of austerity on health system Some improvements up to August 2012 Reversal of progress made More people waiting longer, except longest Aug 2013, 1000 waiting 1 yr +, 4,792 waiting 9 months + but overall more people waiting Aug 2013: 374,104 outpatients waiting, 2,236 4 yrs+, 6,008 3 yrs+, 20,501, 2 yrs+, 55,422 1 yr+ Target by Dec 2013 no one 1yr+ OPD, 8 mths elective System reaching breaking point?

12. Programme for Government commitments to older people? This government is the first in the history of the State that is committed to developing a single-tier health service which guarantees access to medical care based on need, not income Universal Health Insurance designed according to the European principle of social solidarity No discrimination between patients on the grounds of income or insurance status Free GP care for all by 2015

13. Programme for Government commitments to older people? Investment in more and better care for older people in the community and in residential settings will be a priority of this Government Additional funding will be provided each year for the care of older people This funding will go to more residential places, more home care packages and the delivery of more home help and other professional community care services Bring down price of drugs

14. The impact of Government health policy on older people Health policy driven by austerity Smaller budget, fewer staff, growing demand – Driving ‘efficiencies’ – Now having to do less with less Transferring cost of care on to people eg drugs Impact of Budget 2014 – 34% over 70s have both medical cards & PHI Mission impossible with €1 billion less

15. Thank you for listening www.resilience4health.com www.saraburke.com