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 ...

Civil society feedback on the Zero Draft of the 2023 Political Declaration on UHC

The 2023 UN High-Level (HLM) Meeting on Universal Health Coverage (UHC) provides countries and all stakeholders with the opportunity to not just recommit to UHC but take concrete actions toward building resilient and equitable health systems. While some progress has been made since the 2019 HLM on UHC that resulted in a comprehensive Political Declaration, more than half of the world’s population still lacks access to essential health services. The situation was further exacerbated by the COVID-19 pandemic.

As the UHC2030 Co-Chairs recently stated in their reflection on the UHC Political Declaration 2023 Zero Draft, Member States must show political leadership and “move from commitment to action”. Following the release of the zero draft of the political declaration, the Civil Society Engagement Mechanism (CSEM) launched a survey to collect feedback from civil society to identify priorities for strengthening the zero draft, and ultimately, the Political Declaration. Over the span ...

Regional framework on the future of primary health care in the Western Pacific

Regional Framework on the Future of Primary Health Care (PHC) was adopted by Member States at the seventy-third session of the Regional Committee for the Western Pacific in 2022. The framework outlines five key attributes of PHC including people and community-centered, continuous, high-quality and equitable, integrated, and innovative. It highlights five strategic areas of actions needed which pivot around models of service delivery, individual and community empowerment, workforce and provider base, financing, enabling and supportive environment to enable this transformation. It calls on critical health system transformation for the future to achieve Universal Health Coverage and Sustainable Development Goals.

World leaders commit to redouble efforts towards universal health coverage by 2030

Today, 21 September 2023, at the United Nations (UN) General Assembly High-Level Meeting, world leaders have approved a new Political Declaration on “Universal Health Coverage (UHC): expanding our ambition for health and well-being in a post-COVID world”.  

The declaration is hailed as a vital catalyst for the international community to take big and bold actions and mobilize the necessary political commitments and financial investments to attain the UHC target of the Sustainable Development Goals (SDGs) by 2030.

The UHC target measures the ability of countries to ensure that everyone receives the health care they need, when and where they need it, without facing financial hardship. It covers the full continuum of key services from health promotion to prevention, protection, treatment, rehabilitation and palliative care. Alarmingly, global progress towards UHC has been largely stagnating since 2015, before stalling in 2019.

The urgency of the declaration is evident in the staggering statistics ...