Health system responses to financial pressures in Ireland: policy options in an international context

Given the scale of the challenge facing the health system for 2013 and subsequent years, the Department of Health invited the European Observatory on Health Systems and Policies to prepare a report on the implications for the Irish health system of our current financial pressures. The Observatory is an international partnership hosted by the World Health Organisation (WHO). The partnership includes three other international agencies (European Commission, the European Investment Bank, World Bank), several national and decentralized governments, including Ireland, and academic institutions. As an independent and neutral knowledge broker the Observatory's core mission is to inform policy-making and decision-making processes by providing tailored, timely and reliable evidence on health policy and health systems. Click here to download PDF 2.1mb

Value for Money and Policy Review of Disability Services in Ireland

This Review is an evaluation of the efficiency and effectiveness of the HSE-funded statutory and non-statutory disability services in Ireland. It was conducted by the Department of Health and the HSE under the auspices of the Governmentâ?Ts programme of Value for Money Reviews for 2009-2011. It makes a range of recommendations about how these services should be structured. www.dohc.ie/press/releases/2012/20120720.html Click here to download PDF 3.7mb Value for Money and Policy Review of the Disability Services Programme – Recommendation PDF 205kb Value for Money and Policy Review of the Disability Services Programme – Questions & Answers PDF 44kb Value for Money and Policy Review of the Disability Services Programme – Questions & Answers PDF 151kb  

Sixth Annual Report of the Independent Monitoring Group for A Vision for Change - the Report of the Expert Group on Mental Health Policy - July 2012

Sixth Annual Report of the Independent Monitoring Group for A Vision for Change – the Report of the Expert Group on Mental Health Policy – July 2012 This is the 6th Annual Report of the Independent Monitoring Group for A Vision for Change (IMG) and the final report of the Second Group. It is clear to the IMG that the implementation of A Vision for Change (AVFC) to date including 2011 has been slow and inconsistent. There is a continued absence of a National Mental Health Service Directorate with authority and control of resources. Such a body has the potential to give strong corporate leadership and act as a catalyst for change. Click here to download HSE National and Regional Progress ReportsHSE – 6th Annual Report HSE – National and Regional Progress Report Progress Reports from Government DepartmentsDepartment of Children and Youth AffairsDepartment of Education and SkillsDepartment of Health Department of Justice and Equality Department of Social ProtectionDepartment of Environment, Community & Local Government National Mental Health Programme Plan Consultation Document What We Heard Submissions Received by the IMGAmnesty International Ireland submission Association of Occupational Therapists submission College of Psychiatry of Ireland submissionCollege of Psychiatry of Ireland – Press Release regarding Social Psychiatry and Recovery Conference College of Psychiatry of Ireland – regarding Psychotherapy Training for Psychiatric TraineesCollege of Psychiatry of Ireland – regarding relationship with Pharmaceutical Industry College of Psychiatry of Ireland – Mental Health in Primary CareDisability Federation of IrelandHealth Research Board submission Irish Association of Social Workers – Adult Mental Health Irish Association of Social Workers – Child and Adolescent Mental Health Irish College of General PractitionersMental Health CommissionMental Health ReformPharmaceutical Society of IrelandIrish Advocacy Network Childrens Mental Health CoalitionNational Disability AuthorityNational Service Users ExecutiveNational Service Users Executive – Second Opinions ReportNational Federation of Voluntary BodiesHeadstrong  

Review of Current Policy for the Retention of Newborn Screening Cards

Dr James Reilly, Minister for Health requested the Health Service Executive to review the policy regarding the retention and disposal of Newborn Screening Cards (NSCs). The NSCs are an integral component of the National Newborn Bloodspot Screening Programme (NNBSP). The Minister had received representations concerning the archived NSCs stored by the National Newborn Bloodspot Screening Laboratory (NNBSL) at the Childrenâ?Ts University Hospital, Temple Street (CUH, T/S).   Click here to download PDF 146kb

Value for Money and Policy Review of Disability Services in Ireland - National Implementation Framework

The National Implementation Framework describes how the recommendations from the Value for Money (VFM) and Policy Review of the Disability Services Programme will be translated into concrete actions. It assigns responsibilities for those actions, and specifies timelines for their completion. It also identifies priorities and key performance indicators. The Framework describes how these reforms can be achieved in a planned, timely and cost effective manner. Click here to download (PDF 876KB)

Value for Money and Policy Review of the Economic Cost and Charges Associated with Private and Semi-Private Treatment Services in Public Hospitals - Final Report

This Value for Money and Policy Review (VFM&PR) of the Economic Cost and Charges Associated with Private and Semi-Private Treatment Services in Public Hospitals was initiated by the Department of Health and Children in June 2009 and was conducted under the auspices of the Governmentâ?Ts Value for Money & Policy Review Initiative 2009-2011. The Review was overseen by an independently chaired National Steering Group comprised of senior representatives from the Department of Health and Children, the Department of Finance, and the Health Service Executive (HSE). Download document here Download Explanatory Note  

Value for Money and Policy Review of the Economic Cost and Charges Associated with Private and Semi-Private Treatment Services in Public Hospitals - Interim Report

This report sets out a revised costing methodology and an estimate of the gap which currently exists between private and semi-private bed charges and the average economic cost. While the Steering Group considers the costing methodology proposed as an improvement on the approach taken in previous years and a good overall approximation of the difference on average between economic costs and current charges, it recognises that the current charging regime does not take sufficient account of the variation between different categories of patient. Download document here Note to Readers

Value for Money & Policy Review: Allocation & Utilisation of Funding in Acute Services in the Southern Hospitals Group in 2006 - Final ReportRelated Documents

This report is a Value for Money (VFM) evaluation, conducted by the National Hospitals Office (NHO) of the Health Service Executive (HSE) on the allocation and utilisation of funding for expenditure in the Southern Hospitals Group (SHG) in 2006. The SHG consists of nine hospitals in the HSE South region. The 2006 expenditure for the SHG covered by the evaluation was 590.1 million. Performance trends were studied over the period 2004 to 2006. Download document here Value for Money & Policy Review of Allocation & Utilisation of Funding in Acute Services in the Southern Hospitals Group (in 2006) – Department of Health and Children Response & Implementation Plan

Establishing a whole school food policy

This guide has been written to help your school develop, write and implement a whole school food policy. It is designed to be easy to follow and based firmly in the context of real school life. This resource was originally developed and produced by the Health Promotion Agency for Northern Ireland as part of the School food: top marks programme and is now the responsibility of the Public Health Agency. It was jointly funded by the Department of Education and the Department of Heath, Social Services and Public Safety.

Policy Diffusion: An Agent-Based Approach

Methods like Event History Analysis can show the existence of diffusion and part of its nature, but do not study the process itself. Nowadays, thanks to the increasing performance of computers, processes can be studied using computational modeling. This thesis presents an agent-based model of policy diffusion mainly inspired from the model developed by Braun and Gilardi (2006). I first start by developing a theoretical framework of policy diffusion that presents the main internal drivers of policy diffusion - such as the preference for the policy, the effectiveness of the policy, the institutional constraints, and the ideology - and its main mechanisms, namely learning, competition, emulation, and coercion. Therefore diffusion, expressed by these interdependencies, is a complex process that needs to be studied with computational agent-based modeling. In a second step, computational agent-based modeling is defined along with its most significant concepts: complexity and emergence. Using computational agent-based modeling implies the development of an algorithm and its programming. When this latter has been developed, we let the different agents interact. Consequently, a phenomenon of diffusion, derived from learning, emerges, meaning that the choice made by an agent is conditional to that made by its neighbors. As a result, learning follows an inverted S-curve, which leads to partial convergence - global divergence and local convergence - that triggers the emergence of political clusters; i.e. the creation of regions with the same policy. Furthermore, the average effectiveness in this computational world tends to follow a J-shaped curve, meaning that not only time is needed for a policy to deploy its effects, but that it also takes time for a country to find the best-suited policy. To conclude, diffusion is an emergent phenomenon from complex interactions and its outcomes as ensued from my model are in line with the theoretical expectations and the empirical evidence.Les méthodes d'analyse de biographie (event history analysis) permettent de mettre en évidence l'existence de phénomènes de diffusion et de les décrire, mais ne permettent pas d'en étudier le processus. Les simulations informatiques, grâce aux performances croissantes des ordinateurs, rendent possible l'étude des processus en tant que tels. Cette thèse, basée sur le modèle théorique développé par Braun et Gilardi (2006), présente une simulation centrée sur les agents des phénomènes de diffusion des politiques. Le point de départ de ce travail met en lumière, au niveau théorique, les principaux facteurs de changement internes à un pays : la préférence pour une politique donnée, l'efficacité de cette dernière, les contraintes institutionnelles, l'idéologie, et les principaux mécanismes de diffusion que sont l'apprentissage, la compétition, l'émulation et la coercition. La diffusion, définie par l'interdépendance des différents acteurs, est un système complexe dont l'étude est rendue possible par les simulations centrées sur les agents. Au niveau méthodologique, nous présenterons également les principaux concepts sous-jacents aux simulations, notamment la complexité et l'émergence. De plus, l'utilisation de simulations informatiques implique le développement d'un algorithme et sa programmation. Cette dernière réalisée, les agents peuvent interagir, avec comme résultat l'émergence d'un phénomène de diffusion, dérivé de l'apprentissage, où le choix d'un agent dépend en grande partie de ceux faits par ses voisins. De plus, ce phénomène suit une courbe en S caractéristique, poussant à la création de régions politiquement identiques, mais divergentes au niveau globale. Enfin, l'efficacité moyenne, dans ce monde simulé, suit une courbe en J, ce qui signifie qu'il faut du temps, non seulement pour que la politique montre ses effets, mais également pour qu'un pays introduise la politique la plus efficace. En conclusion, la diffusion est un phénomène émergent résultant d'interactions complexes dont les résultats du processus tel que développé dans ce modèle correspondent tant aux attentes théoriques qu'aux résultats pratiques.

A Study of a Staff Alcohol Policy in a Large Public Health Organisation, Looking at the Policy Content, the Policy Development and the Implementation Process, and the Policy Impact

There are different approaches to dealing with alcohol related problems in the workplace. A literature review indicates that two of the models that underpin programmes to deal with alcohol related problems in the workplace are the disease model and the health promotion model. The disease model considers alcoholism as an illness and uses curative techniques to restore the individual to sobriety. The health promotion model looks at the determinants of health and promotes changes in the environment and structures, which would support healthy behaviour in relation to alcohol. Employee Assistance Programmes (EAPs) may have elements of both theses models. Dealing with alcohol problems at work involves a captive audience and the workplace as a setting can be used to influence healthier lifestyles. A workplace alcohol policy is a mechanism through which alcohol related issues might be dealt with, and the necessary resources and commitment of managers and staff channelled to this end. The policy aims should be clear and unambiguous, and specific plans put in place for implementing all aspects of the policy. In the case of the alcohol policy in the organisation under study, the policy was underpinned by a health promotion ethos and the policy document reflects broad aims and objectives to support this. The steering group that oversaw the development of the policy had particular needs of their own which they brought to the development process. The common theme in their needs was how to identify and support employees with alcohol related problems within an equitable staff welfare system. The role of the supervisor was recognised as crucial and training was provided to introduce the skills needed for an early intervention and constructive confrontation with employees who had alcohol related problems. Opportunities provided by this policy initiative to deal with broader issues around alcohol and to consider the determinants of health in relation to alcohol were not fully utilised. The policy formalised the procedures for dealing with people who have alcohol related problems in an equitable and supportive manner. The wider aspect of the health promotion approach does not appear to have been a priority in the development and implementation of the policy.This resource was contributed by The National Documentation Centre on Drug Use.

The policy-making structure of European regulatory networks and the domestic adoption of standards

European regulatory networks (ERNs) constitute the main governance instrument for the informal co-ordination of public regulation at the European Union (EU) level. They are in charge of co-ordinating national regulators and ensuring the implementation of harmonized regulatory policies across the EU, while also offering sector-specific expertise to the Commission. To this aim, ERNs develop 'best practices' and benchmarking procedures in the form of standards, norms and guidelines to be adopted in member states. In this paper, we focus on the Committee of European Securities Regulators and examine the consequences of the policy-making structure of ERNs on the domestic adoption of standards. We find that the regulators of countries with larger financial industries tend to occupy more central positions in the network, especially among newer member states. In turn, network centrality is associated with a more prompt domestic adoption of standards.