Systems, not structures: Changing Health & Social Care

In his speech of 4 November 2015, the then Minister for Health, Simon Hamilton MLA, announced that in response to recommendation 1 of The Right Time, The Right Place report by Sir Liam Donaldson, he would appoint an expert, clinically led panel to consider and lead an informed debate on the best configuration of Health and Social Care services in NI.

The Panel was appointed in January 2016 and comprised local and international members.

PANEL MEMBERS

Professor Rafael Bengoa (Chair)
Dr Alan Stout
Bronagh Scott
Mairead McAlinden
Mr Mark A Taylor

EXPERT ADVICE ON SOCIAL CARE WAS PROVIDED BY:

Sean Holland
Fionnuala McAndrew

THE PANEL WAS SUPPORTED IN ITS WORK BY:

Alastair Campbell
Vikki Greenwood
Catherine Tumelty

Introducing The Lancet Global Health Commission on financing primary health care: putting people at the centre

Benefit design: the perspective from health financing policy

Given the central importance of public financing to make progress towards universal health coverage (UHC), government policy on benefit design, including both service entitlements and conditions of access, significantly influences health system performance. Benefit design considers how all public funds are used and should be based on evidence and developed through a systematic process involving key stakeholders. Reducing uncertainty over entitlements and conditions of access, in particular co-payments, both reduces barriers to accessing services and improves financial protection. Finally, aligning benefit design with a range of health financing policies, as well as service with delivery objectives, provides a powerful way through which policy makers can drive positive change in their health systems.

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The Lancet Global Health Commission on financing primary health care: putting people at the centre

Challenges, progress, opportunities: European and Central Asian health systems

New WHO studies look at health systems across 14 countries in Europe and Central Asia to reveal how to better invest in the health of millions Allowing policy-makers the chance to compare and collaborate, recent studies from the World Health Organization present countries’ health systems at a glance.

Many citizens in the WHO European Region are fortunate to live in countries where the health system can look after them when they fall ill. But sadly, for millions of others, falling ill means having to choose between paying for medical treatment and paying for food, education and other necessities.

In some countries in Eastern Europe and Central Asia, more than half of health spending is paid out of pocket when people use health services, rising above 70% in some cases. When government’s public spending for health care is low, households face hardship and financial ruin. This needs to change, and ...

Improving home care sustainability in Ireland. Are user charges a promising option?

There are often concerns that population ageing will cause health and long-term care expenditures to grow uncontrollably. A key question facing decision-makers is what, if anything, can be done in response? In this report we consider whether user charges would improve the financial sustainability of home care in Ireland, a country which is ageing at a rate similar to other high income countries.

We find that user charges are an inefficient tool to try to reduce the home care financing gap. Evidence suggests that the revenues raised for home care through user charges are negligible in other high income countries. Additionally, while user charges may cause some people to reduce their demand for care, service-users are typically unable to distinguish between high-value and low-value care. Some service-users who do continue to use services will experience financial hardship if required to pay user charges out-of-pocket, while others will forgo care. In ...