I thank the Chairman and members for the invitation to discuss my re-appointment to the position of chairman of the NTPF. I also thank the Minister for Health, Deputy Harris, for re-nominating me to the position. This confirmation process provides a welcome opportunity to discuss my vision for the future contribution of the NTPF and for my role as chairperson. In order to do that and by way of providing the committee members with some background material I have in recent weeks forwarded to each member copies of my curriculum vitae, together with the NTPF’s strategy and action plan for the years 2017 through 2019. I propose therefore by way of this opening statement to deal briefly with these two matters.
In the first half of my career I held a variety of positions in both operating and service departments in Aer Lingus. During that time I had extensive involvement at board level with the airline’s wide-ranging list of subsidiary companies involved in what were then known as ancillary activities. For much of the following 20 years, I led two national organisations as chief executive, namely, the Irish Hotels Federation and then Veterinary Ireland. At home, this work involved extensive dealings with Departments, public bodies and the media, while abroad on the international front I represented these sectors in international organisations in dealings with a range of bodies, particularly at a European level. In the course of this work I was nominated by IBEC to be a member of the Employment Appeals Tribunal, EAT, uniquely at a time when I was a serving general secretary of a trade union affiliated to the Irish Congress of Trade Unions. Having served almost ten years with the EAT, this work is coming to an end with the amalgamation of the EAT into the newly created Workplace Relations Commission.
On the community front, on behalf of Blessington and District Forum I have served on a Fáilte Ireland tourism destination development steering group and have particularly championed the development of a new greenway around Blessington lakes. I have also been appointed by Kildare and Wicklow Education and Training Board as one of its nominees to the board of management of Blessington community college. On the academic front I hold a masters degree in management practice from the Irish Management Institute and Trinity College, Dublin. In addition to the above I was honoured to be asked to serve on the board of the NTPF, a body which has carried out some great work in delivering faster treatment to hundreds of thousands of patients in the public health care system.
While not wishing to delve too much into the history of the organisation, it is worth noting that from its establishment on an administrative basis in 2002 and on a statutory basis as an independent agency in 2004, the NTPF succeeded in reducing waiting times for public patients from their original levels of two to five years down to an average waiting time of two and a half months. This was achieved through the direct commissioning of patient-level treatment for public patients by the NTPF, mostly in private hospitals.
In 2009, the nursing home support scheme, referred to colloquially as the fair deal, was established and the NTPF was given a key role in the pricing of long-term residential care. In what is a vitally important task in terms of its importance both for the users of the system and for national finances, the NTPF has delivered consistently in setting up the system of agreeing prices with more than 400 nursing homes and achieving satisfactory results over the years. I should say that we are currently working with both the Departments of Health and Public Expenditure and Reform in a review to ensure that viable and effective systems continue to be provided for both providers and users of long-term residential care throughout the country.
A decision made in 2012, reflecting then Government policy, assigned additional responsibilities to the NTPF and effectively signalled the end of the organisation’s direct patient treatment commissioning role. It also produced major change in the operational framework of the NTPF, as this commissioning work had represented a significant part of the activity of the NTPF since its inception. The result was that the organisation re-focused its efforts to support the scheduled care system in areas such as data and analytics, negotiation of nursing home prices and audit and quality assurance. Through these efforts, the organisation continued to provide valuable support services to the broader health care system at a time when it was undergoing significant change and reform. During this period of change and uncertainty, the organisation reduced its staffing levels to reflect the changing roles and the reduction in annual budgets.
In more recent years the role and function of the NTPF have been clarified and have evolved in line with Government policy but the original intention has always remained the same, which is to achieve the faster treatment of patients. On foot of the decision of the Minister for Health, Deputy Harris, in 2016 to re-establish the individual patient level commissioning role of the NTPF, and importantly with the associated enabling funding, the organisation is particularly well placed to make again an increased positive and valuable contribution towards shorter waiting times for patients. I say this with confidence based on the proven track record of having done so in the past.
In 2014, a new NTPF board was appointed. It was one of the first selected under the Public Appointments Service process. This board has a wide range of skills covering areas such as medical, legal, accounting, IT, procurement, personnel and general management. While continuing to oversee the ongoing operations of the organisation, the board applied itself particularly to the task of preparing the organisation through the development of a detailed strategy and action plan, all aimed at supporting performance improvement for the faster treatment of patients. The outcome of this work meant that the NTPF was well placed to support the commitments contained in the programme for a partnership Government of 2016 pertaining to the specific funding allocated to the organisation to reduce waiting lists in 2017 and 2018.
In the strategy and action plan, which I have circulated to members in advance, it can be seen that we have established six key objectives that must be achieved to ensure that we deliver successfully on our overall strategic intent between the present and 2019. We aim to negotiate pricing agreements and purchase quality care from providers on behalf of the State. In this regard our second strategic objective is to ensure that a sustainable and fair market exists for long-term residential care with sufficient capacity to meet the requirements of those who require such care. We will continue to publish and share quality-assured waiting list information in respect of public health services.
This is designed to ensure our key partners and stakeholders in the health care system are equipped, in a timely manner, with the necessary data and tools to make decisions that will ultimately lead to patients being treated faster.
A further objective in this regard will be to develop performance improvement tools that will equip operational managers in the delivery system to manage resources in the most efficient, effective and equitable manner possible. We will also provide advisory expertise for the public health service on patient treatment pathways for scheduled care and waiting lists for primary and community care. While doing all this, as chairman leading a strong board of directors, I will ensure the National Treatment Purchase Fund governance and operational infrastructures are fit for purpose in delivering and communicating our strategic objectives for the treatment of long waiting patients.
On corporate governance, I am pleased that we now have our full complement of board members. Using the services of the Public Appointments Service, we have recently recruited a new full-time chief executive. This was a key part of the reactivation of the NTPF's role of commissioning patient treatment, as is the rebuilding of our staffing resources to support the work of reducing waiting times for the longest waiting patients.
To deliver on the requirements placed on the organisation under the programme for Government 2016 the NTPF's budget has been increased to €20 million in the current year, with a further €55 million committed for 2018. I am pleased to report that the preparatory work for the resumption of commissioning of patient treatment has been completed and detailed arrangements have been made with private hospitals to commence the work. Day case patients are already in the system and more are being placed on treatment pathways. A further tranche of funding will be committed very shortly to an insourcing initiative, under which up to €5 million will be spent on treating patients in public hospitals for specific procedures and treatments. In the second half of the current year a third phase of spending will be determined based on our experience with the first two elements and this may be a mixture of inpatient and day cases, all of which will be aimed at reducing the list of patients waiting for treatment for more than 15 months as at the end of October 2017. Looking ahead, our decisions on the specific uses for next year's funding allocation will be informed by our experiences with this year's approach.
As members will realise, these amounts of money on their own will not solve the waiting list problem. However, they will contribute to that process. More importantly, thousands of long waiting patients will receive their treatments faster and, I hope, be enabled to get on with their lives.
I reassure the joint committee that my objective, as chairman of the board, will be to ensure the National Treatment Purchase Fund continues to be well directed and managed in accordance with all appropriate governance requirements. We have a cohort of board members and a committed executive team and employees giving us a base of significant experience and skills. Our aim will be to ensure the functions allocated to us by the Government are carried out effectively and efficiently and that we will be in a position to demonstrate that all funding voted to the organisation is being spent, as intended, to reduce waiting times for patients in the public health care system. I will be pleased to answer questions members may have.
