A PRESCRIPTION FOR CHANGE

Sinn Féin’s Healthcare Plan

25 Key Proposals

arrow_triangle right_alt icon Deliver free prescription medicines for all households, abolish prescription charges for medical card holders, and increase medical card entitlements to the median income.

arrow_triangle right_alt icon Enact Healthcare for All legislation to set the path to full public health cover by 2035.

arrow_triangle right_alt icon Deliver 5,000 hospital beds by 2031, including replacing 1,000 unsafe beds, to set the course for eliminating use of hospital trolleys.

arrow_triangle right_alt icon Implement Sinn Féin’s €250 million Mental Health Action Plan to deliver comprehensive early intervention, primary, community, and acute mental health services, particularly for young people.

arrow_triangle right_alt icon Develop a No Child Left Behind health waiting list strategy to improve paediatric orthopaedic and urology services, expand dental screening in schools, revolutionise children and youth mental health services, and improve children’s disability services.

arrow_triangle right_alt icon Give a job guarantee to Irish health graduates and lead a campaign to engage healthcare workers who left the health service or who left Ireland and implement the changes they need to see.

arrow_triangle right_alt icon Plan to recruit 40,000 healthcare workers over 5 years, and maximise domestic training, attracting Irish workers home, re-activation, and international recruitment to achieve this, as part of a funded multiannual workforce plan.

arrow_triangle right_alt icon Target €1 billion in savings and efficiencies across the health service, including major reductions in agency spending, reliance on overtime, and management consultants

arrow_triangle right_alt icon Develop a landmark public GP contract, employ 250 public GPs, improve out-of-hours and urgent care, and increase GP training capacity by 60%

arrow_triangle right_alt icon Pursue a ‘home first’ approach to care, develop a modern home care scheme, and prioritise public home care delivery of 5 million additional home care hours.

arrow_triangle right_alt icon Double CAO entry places for medicine, nursing, and health and social care courses, and significantly expand access to medicine for domestic students, and expand the Free Fees Initiative to graduate entry medicine.

arrow_triangle right_alt icon Deliver four new elective-only public hospitals and regional surgical centres to tackle waiting lists and implement our Comhliosta integrated waiting list reform.

arrow_triangle right_alt icon Invest in a model 3 hospital with a second emergency department for the Midwest.

arrow_triangle right_alt icon Invest €2 billion in digital transformation to bring the health service into the 21st century.

arrow_triangle right_alt icon Hire public dentists and dental care teams to target school screening for children and medical card holders, and increase dental training places by 32%.

arrow_triangle right_alt icon Deliver a Pharmacy First model for common conditions and the provision of health information and advice, with an expanded and integrated role for pharmacists in primary care.

arrow_triangle right_alt icon Deliver 2,000 community beds, including 1,200 short- and long-stay residential care, nursing, and rehabilitation beds, and deliver full regional community neuro-rehabilitation networks.

arrow_triangle right_alt icon Develop and resource a comprehensive workforce plan to fully staff Children’s Disability Network Teams and conduct an evidence-based and independent review of the service delivery model, and end pay disparities for core service providers.

arrow_triangle right_alt icon Double the number of Personal Assistance hours over a term of Government, provide an additional 1.5 million disability home care hours, provide over 3,000 additional residential places, deliver on de-congregation commitments, significantly expand day services, and double investment in respite services over the term of government.

arrow_triangle right_alt icon Develop a common, compliant, and efficient process for assessment of need under the Disability Act.

arrow_triangle right_alt icon Implement an extensive set of policies to support Health Promotion and Prevention, and embed a prevention approach across strategies for cancer, cardiovascular disease, and more.

arrow_triangle right_alt icon Review the Disability Act 2005 and EPSEN Act 2004, ensure the State is complaint with existing disability and equality legislation, and work systematically towards full compliance with the UNCRPD.

arrow_triangle right_alt icon Implement our 5-year Community Addiction and Recovery Strategy, return funding to historic-high levels for local and regional drug and alcohol taskforces, and initiate an unprecedented investment in community addiction and recovery inpatient capacity.

arrow_triangle right_alt icon Develop a life-course structured care programme in women’s health to improve screening, primary, community, and acute services that are tailored to every stage of a woman’s life, including free access to HRT and contraception.

arrow_triangle right_alt icon Provide multi-annual funding certainty for the cancer strategy, cardiovascular health, diabetes, rare diseases, and other strategic improvement programmes.

Five First 100 Days Commitments

icon_check icon Legislate for free prescription medicines for all and the biggest expansion of medical cards in decades.

icon_check icon Commence negotiations for a public GP contract.

icon_check icon   Publish a revised health bed plan for 5,000 hospital beds out to 2031.

icon_check icon Task HIQA to recommend a location for a second ED in the Midwest.

icon_check icon Establish a Rural Health Commission to develop a 10-year rural health strategy.

* Measures in this section are funded under other headings.
** Undergraduate places funded through FHERIS.

EXECUTIVE SUMMARY

VISION

Sinn Féin has developed a multi-annual and sustainable plan to deal with overcrowding, reduce waiting lists and wait times, improve patient safety, and deliver free-at-the-point-of-use healthcare. We would work across the 32 counties to develop a first-class, all-Ireland National Health System that learns from the best and worst in both jurisdictions and across Europe. Our vision for an Irish NHS would deliver a publicly funded healthcare system for Ireland which recognises physical and mental health as a human right.

This is the most comprehensive health plan produced since the Sláintecare Report of the Joint Oireachtas Committee on Health, containing more than 350 specific policy commitments. This plan delivers on the core principles of Sláintecare, because while Fine Gael and Fianna Fáil have failed to deliver universal healthcare, Sinn Féin remains committed to that objective. We will deliver the necessary reforms which were promised, and we have outlined a practical and realistic roadmap to universal healthcare in this document. Sinn Féin will finish the job and take the Sláintecare programme into a new decade.

A Sinn Féin Taoiseach would appoint a Minister for Health and Social Care to be the driver of the reforms set out in this manifesto. We would establish Cabinet Committees on Health and on Workforce Planning, which would include a major focus on the health sector. The underpinning principle of reform should be that people can access the right care, in the right place, at the right time, and at the most appropriate, cost-effective level, with a strong emphasis on prevention and public health. We would ensure rights-based access to care for disabled people, and inclusive mainstream services.

We have worked closely with healthcare workers, patients, parents, advocates, researchers, officials, executives, and other key stakeholders and policymakers to develop a plan that is realistic, practical, and deliverable, but which is also ambitious. We consider ambition as a minimum standard when it comes to our health, and the health of the people of Ireland.

The problems of waiting lists, overcrowded emergency departments, runaway spending, difficulties accessing GPs and mental health services, and beyond are not new and are well documented. This manifesto sets out how Sinn Féin would improve the health service to address these problems. Our plan spans all care sectors, supporting best practice, challenging the worst inefficiencies and inequities across the health system, and recognising that deliberate investment is needed to deliver reform. It addresses capacity, processes, workforce planning, and resourcing in a coherent, strategic, and joined up way.

Access to Services

Sinn Féin’s 5 Key Priorities in Health and Social Care are:

arrow_carrot right_alt icon  Take Big Bold Steps towards Universal Healthcare

arrow_carrot right_alt icon  Upgrade and Expand Local Health Services

arrow_carrot right_alt icon  Drive Major Reform of Hospital Care

arrow_carrot right_alt icon  Revolutionise Youth Mental Health

arrow_carrot right_alt icon  Deliver a Rights-Based Approach to Disability Services

Sinn Féin would take big bold steps to deliver universal healthcare by providing free prescription medicines for all households, upgrading every GP visit card to a full medical card, providing full medical card cover to all workers up to the median income, and abolishing prescription and car parking charges. In the first 100 days, Sinn Féin would legislate for free prescription medicines and for medical card entitlements for all up to the median income and deliver this over 5 years. We would deliver a Healthcare for All Act to commit the State to full public health cover by 2035. This bundle would cost €1 billion in current expenditure.

A Sinn Féin Government would deliver on the commitment of Sláintecare to deliver the right care in the right place at the right time. This would be achieved by upgrading and expanding local health services with a landmark public GP contract, hiring public dentists, delivering a Pharmacy First model for minor ailments, and ramping up home- and community-based care.  Our comprehensive plan covers essential measures to reform home care, expand GP and primary care, deliver community neuro-rehabilitation teams, and reduce pressure on hospitals. This bundle would cost €852 million in current expenditure.

A Sinn Féin Government would set a zero-tolerance approach to hospital trolleys and overcrowding as a target for all hospitals. To achieve this, we would deliver 5,000 hospital beds by 2031, including replacements for 1,000 unsafe beds. We would also invest in diagnostic capacity, theatre space, and aligned discharge capacity in the community, and accelerate the delivery of public only elective hospitals. This would be underpinned with community care reform, including 2,000 community step-down, nursing care, and social inclusion beds, and legislation for safe staffing levels. This bundle would cost €1.584 billion in current expenditure.

A Sinn Féin Government would not tolerate an understaffed and under-resourced mental health service. At the heart of Sinn Féin’s plan is a new Child and Youth Mental Health Service to replace CAMHS which would provide integrated early intervention services for children and young people to the age of 25, expand access to Jigsaw and primary care mental health services, deliver universal counselling, fund the full complement of inpatient and intellectual disability CAMHS teams, and deliver 20 more early intervention in psychosis teams. This bundle would cost €250 million in current expenditure.

A Sinn Féin Government would implement an unprecedented 10-year investment programme to deliver a rights-based approach to disability services. This would provide for unmet and future need, and fund accessible therapies, respite services, residential care and de-congregation, personal assistance services, home support hours, day services, and access to specialist and mainstream community services. For the first five years, this bundle would cost €829 million in current expenditure.

Our ambitious plan for health and social care includes, but is not limited to women’s health, children’s services, national strategies, all-island planning, public health, social care, disabilities, older people, chronic disease management, gender and sexual health, prevention and health promotion, and climate action in health. This bundle would cost €502 million in current expenditure. We have provided a standalone funding programme for addiction and recovery, which would cost €150 million in current expenditure.

Workforce planning is one of the key enablers of delivering our plan. The Health element of our workforce plan, excluding Higher Education, would cost €229 million in current expenditure. This would increase clinical and specialist training places, and support an expansion of clinical specialist and advanced practice staffing. We would double health undergraduate places and we have accounted for this in our Further and Higher Education budget. We estimate that our plan would need 40,000 full time health and social care workers.

Funding and Delivery

The health service needs real reform. We are proposing a total package of new measures valued at €5.4 billion. This is funded through €3.6 billion in additional current expenditure for the Department of Health, €829m in additional current expenditure for the Department of Disability, and €1 billion in savings and efficiencies by 2030, as set out in the Accountability and Reform section. This is exclusive of additional funding for existing levels of service, which must be evidence-based and account for year-to-year cost pressures such as inflation, demographics, and pay increases.

This built-in savings target of at least €1 billion requires a reprofiling of baseline expenditure totalling 4% of the current health budget. We would set rising targets averaging €200 million in savings each year for five years. In the context of significant additional investment, new technology, and more sustainable care systems, we believe these are at the lower end of what can be achieved. A Sinn Féin Government would seek to achieve the maximum savings possible but for the purposes of our funding plan, we are setting a minimum target of €1 billion to part-fund our additional measures. This is a necessary adjustment to ensure the sustainability of the health budget into the future. No funding plan would be credible without a substantial savings target.

Sinn Féin would deliver a €15-billion health capital investment programme over the next term of Government. We would use €2 billion from the Apple Tax Money as well as an allocation to the National Development Plan to immediately provide funding certainty for 5,000 acute hospital beds. This ambitious and future-focussed capital programme includes estimates for 4 new elective hospitals, the new maternity hospital, surgical and diagnostic hubs, new primary care centres and community facilities, 5,000 hospital beds, theatre capacity, nursing homes, equipment, machinery, ambulance fleet, and other significant and minor infrastructure works. It also includes estimates to maintain existing stock, advance climate action, and meet regulatory standards. We would specifically ringfence €2 billion for a Digital Transformation Fund.