The Budget
We heard this week that 2015 will see an increase of Exchequer funding of €305 million for health, this the first increase in seven years, bringing the health budget for next year to €13.079 billion. Further once-off revenue measures of €330 million were also announced to support services.
This means there will be an increase of €635 million in current spending for the health services compared to the start of 2014. The total capital budget for 2015 will be a further €382 million.
The increase in health funding is to be welcomed, however it will not be for a few weeks when the HSE publishes its Service Plan for 2015, that we will learn the real detail in next year’s health budget.
One of the big announcements in Budget 2015 that is the provision of funding to extend Breast-Check the National Breast cancer-screening programme to women between the ages of 65 to 69. This is something, which the Irish Cancer Society has been campaigning for since 2011.
One in ten of all breast cancers occur in the 65-69 age group. The International Agency for Research on Cancer (IARC) says that quality screening mammography carried out every two years in women who are 50-69 years of age should reduce their risk of dying from breast cancer by about 35%. This means that one life will be saved for every 500 women screened.
Another big-ticket item announced on Tuesday was the provision of €25 million to tackle delayed discharges. This is where patients who are clinically fit for discharge are forced to wait in hospital beds due to a lack of step down facilities.
Speaking at the press briefing on the health budget on Tuesday the Minister for Health Leo Varadkar said: “Funding of €25 million is being set aside for delayed discharges. This will be targeted at hospital and community services which can demonstrate initiatives to address the specific needs of delayed discharge patients most positively, and thereby improve timelines for admissions from Emergency Departments and waiting lists.”
There are currently approximately 700 people in this situation in acute hospitals all around the country. These patients, the vast majority of whom are elderly and frail, are often described as “bed-blockers”. This is a highly derogatory term and one, which points the finger of blame at this cohort, depicting them unfairly as the reasons for, rather than the victims of, a broken system.
We are not sure yet what the €25 million will be spent on and whether it will be simply swallowed up by the Fair Deal scheme which is currently under huge pressure.
While undoubtedly more resources are needed for nursing home places, it is hoped is that some of the €25 million will be used to provide community supports to allow older people to remain in their own homes for as long as possible.
While there were some public health initiatives in Budget 2015 such as the increase in the cost of tobacco products, the Government did not increase the cost of alcohol. This move was criticised by the Royal College of Physicians of Ireland (RCPI). Prof Frank Murray, President Designate of College and chair of its policy group on alcohol said he was disappointed with the absence of any initiatives in the Budget to impact on the consumption of alcohol, particularly of cheap alcohol.
Ebola
In other news, The World Health Organisation (WHO) has stated that a total of 8,997 confirmed, probable, and suspected cases of Ebola virus disease (EVD) have been reported in seven affected countries (Guinea, Liberia, Nigeria, Senegal, Sierra Leone, Spain, and the United States of America) up to the end of October 12. There have been 4,493 deaths from the disease.
On 6 October 2014, the WHO was informed of the first confirmed case of EVD in Spain, this was the first human-to-human transmission of EVD outside Africa.
On Thursday the Minister for Health Leo Varadkar told the Oireachtas Health Committee that it was time to step up preparedness in response to the threat of Ebola to these shores.
According to the Minister “though it is unlikely it is possible and we have seen already the number of healthcare workers being infected in Spain and Texas. For this reason we now need to step up our preparedness this will involve training in particular at hospital level it will involve dry runs and the provision of further equipment.”
Earlier this week the Irish Medical Organisation expressed a number of concerns in relation to preparations for dealing with suspected cases of Ebola here. The IMO warned the HSE of its concerns that must be addressed as part of the arrangements being put in place by the HSE to deal with the matter.
Professor Trevor Duffy, IMO President said: “Obviously everyone in this country hopes that the Ebola virus is a problem that we never have to deal with. But in the event that there are incidents of the virus that emerge here or scares about potential incidents, it is critical that we have arrangements and structures in place. ”
According to the Health Protection Surveillance Centre “Ebola is unlikely to be imported into Ireland. There have been a small number of cases in countries outside Africa, however healthcare providers have been advised to be alert for and evaluate any patients suspected of having Ebola.”
Freeze your Eggs – Free Your Career?
Moving on to my last and one of the strangest stories of this week is the news that some American technology companies are offering their female employees an option to delay motherhood to presumably concentrate on their careers.
According to reports these companies are offering to fund the cost of egg freezing procedures for their female employees.
Quoted in the Irish Examiner this week Dr John Waterstone, Medical Director at the Cork Fertility Centre said his concern was that egg freezing was not tremendously successful. He said research published in international journal Fertility and Sterility in 2013 showed the chance of a woman having a baby after having eggs frozen at age 25 was 31.5%. That reduced to 19.3% when the woman was aged 35 at the time of the procedure.
“Offering to pay for egg freezing is almost encouraging women to delay having babies even further,” he said.
“Egg freezing is not a perfect science and there is a big chance the eggs won’t work. It is completely different to freezing sperm, which is very robust and freezes well. Perhaps a more responsible approach would be to make it easier for women to have kids younger by allowing them take more time off and having more family-friendly policies.”