More patients will self manage

More patient self-management will be a feature of the health services in the future, Mr. Kieran Ryan, CEO, Irish College of General Practitioners, told the 9th National Health Summit in Dublin.  Maureen Browne reports.

More patient self-management will be a feature of the health services in the future, Mr. Kieran Ryan, CEO, Irish College of General Practitioners, told the Conference.

He said that many drugs which were now only available in hospital would become available at primary care and indeed home level, which would affect cost control and empower patients to manage their own health. Wellness was the way to go and primary care was the only place to focus on wellness.

“At present primary care teams are very much hit and miss and the definition and understanding of teams is very variable and there are not as many out there as we thought.”

Mr. Ryan said that 95 per cent of GP services used electronic patient management systems, but the lack of a unique patient identifier was a huge barrier to integration between primary care and the hospital services.

“We need to look at the business environment of primary care. By and large most GPs in private practice have invested in their own property and employ their own people. There are about 1,600 practices employing two to three people, which is a major benefit to the economy. There is great uncertainty about UHI, if GPs will be salaried and how will it affect the business.

If all existing private patients were to be converted to public patients at 2009 rates, the highest risk exposure would be about €800 million.

Mr. Stephen McMahon, CEO, Irish Patients Association said that they had estimated that if all existing private patients were to be converted to public patients at 2009 rates, the highest risk exposure would be about €800 million.  Prices had come down since then.

Ms. Laverne McGuinness, HSE National Director for Integrated Care said that 90 per cent of all health care could be provided in primary care rather than in hospitals. The Department of Health strategy was for 484 Primary Care Teams. There were 426 PCTs in place at present. Not all were fully staffed compared to what they should be. About 40 per cent would be fully functioning and working very well. Others were at different stages due to staff leaving and non replacement.  This year there was a budget of €20 million for about 250 era staff in PCTs.

“I would see the PCTs as the first step in putting together the infrastructure to deliver the primary care service we need here in Ireland, and to keep people well.  They are the core stepping stones.”

There were 426 PCTs in place at present. Not all were fully staffed compared to what they should be.

She said the HSE had put in place a national audiology programme as part of primary care. “Our aspiration is for 90 per cent of care to be delivered in the community, which is a big challenge. We need to negotiate a new GP contract and a mindset change that where appropriate, care in the community is as good as care in hospitals.