Federal National Plans

The FederalNational Plans were a series of policy papers, published by Marissa Santini as President of the Government and her Council of State, in Nouvelle Alexandrie, between II.1730 AN and IV.1730 AN. They were the result of the budgetary decisions of the General Appropriations and Taxation Act, 1730, and the policy priorities as stipulated by the Government Delivery Plan. They included the:

• National Infrastructure Plan
• National Health Plan
• National Plan for the Police
• National Armed Forces Plan
• International Cooperation Plan

History

The results of the New Alexandrian general election of 1729 led to the Federal Consensus Party gaining a plurality of the vote. Together with United for Alvelo and the Democratic Socialist Party, they formed a minority government with the other parties giving confidence and supply. Marissa Santini announced three of the plans (Health, Police, and Rail) during the Throne Speech Debate. Much of the plans evolved from the New Consensus book published in 1714 AN, and from the 1729 Election Campaign.

The plans were devised by the respective Departments, with input from the Office of the President's Department of National Affairs. The DNA for this purpose designated specific Implementation Coordinators for the largest plans - Infrastructure, Healthcare, Police - to oversee the management and implementation of each plan through the Coordination Unit. The Department of Political Affairs also collaborated for purposes of macroeconomic analysis and management.

The National Rail Plan, finished as first, was eventually subsumed into the larger Infrastructure Plan, which also included policies on roads, airports, and waterways. The International Cooperation Plan was added to create a coordinated document for Raspur Pact and Micras Treaty Organization Expansion.

National Infrastructure Plan

The national infrastructure plan was devised by the Department of Civil Works and Transportation (Nouvelle Alexandrie), in collaboration with Nouvelle Alexandrie Railways, AirAlduria, and the Federal Highways Agency. It created an ambitious plan for high-capacity, efficient, and modern connections on road, rail, airport and water. It worked to respond to the growing population, growing urban sprawl, and evolving demands in infrastructure and transit needs.

Road, Bridges, and Major Projects

The Road and Highways Strategy build upon the successes of the Pan-Keltian Highway and Pan-Euran Highway, as well as the ongoing efforts of the Pan-Lyrican Highway. In total, it represents over €171 billion, across a total of seven other programs that were created, or expanded:

• the National Highways Program, is the federal funding program that supports and invests in highway construction, maintenance of highways, and improving safety and reliability of highway operations.
  • It included three major extension projects for the Pan-Keltian Highway (Boriquén and New Caputia) and Pan-Euran Highway.
  • It included the National Highway Network Upgrade Plan, to upgrade highways across the nation, improving safety and reliability, reducing congestion and emissions, and creating new highway facilities; divided across three sub-programs:
    • The Highway Charging Infrastructure Program;
    • The Highway Noise & Emission Reduction Program; and
    • The Highway Wildlife Crossing Program.
  • It included the National Highway Network Freight Highways Projects, funding Regions and local governments with competitive grants for multimodal freight and highway projects of national or regional significance to improve the safety, efficiency and reliability of the movement of freight and human capital in and across rural and urban areas.
  • It included the Regional Highway Construction and Rehabilitation Program, supporting Regions and local authorities with non-Federal highway construction, maintenance, and rehabilitation; including the construction of secondary and tertiary roads.
  • It included the National Highway Corridor Planning and Development Program, funding Regions and city planning organizations for coordinated planning, design, and construction of corridors of national significance, economic growth, and international or interregional trade; including highway facilities, interchanges, and bypasses.
  • It included the Intelligent Transportation Systems Deployment and Integration Program, funding ITS integration and interoperability in cities and rural areas; including real-time management systems and monitoring.
  • It included the National Highway Network MegaProjects, providing funding for large, complex highway projects that are difficult to fund by other means and likely to generate national or regional economic, mobility, or safety benefits; including rail-highway grade separation projects and intercity high-capacity highway projects.

• The Surface Transportation Grant Program, funds projects that promote flexibility in Regional and local transportation networks, including flexible funding for Regional and local transportation decisions based on regional and local needs.
  • It included the Roads, Bridges and Tunnels Program, providing funding to Regions and local authorities to invest in their regional non-Federal highways and roads, bridges, and tunnels infrastructure.
  • It included the Road Safety and Accidents Program, providing funding to Regions and local authorities to invest in road safety measures; including data collection and road maintenance.
  • It included the Urban Charging Infrastructure Program, providing funding to Regions and local authorities to establish EV charging infrastructure.
  • It included the Bicycle Transportation and Pedestrian Walkways Program, providing funding for projects for the construction, expansion, and maintenance of pedestrian walkways and bicycle transportation facilities and for carrying out non-construction projects related to safe bicycle use.
• The Bridge Formula Program, is the federal funding program to support bridge replacement, rehabilitation, preservation, protection or construction projects on public roads.
  • It included the Highway Bridge Program, to  replace, rehabilitate, upgrade,and repair highway bridges, including funding for maintenance, anti-icing, and painting expenses.
  • It included the Off-System Bridge Program, to replace, rehabilitate, upgrade, and repair off-system bridges, including funding for maintenance, anti-icing, and painting expenses; meaning bridges by cities, counties, townships, or privately - those ineligible for Federal highway funding.
  • It included the Innovative Bridge Research and Development Program, providing grants, cooperative agreements, and contracts for Regions, local authorities, universities and colleges, private sector entities, and non-profit organizations for federal funding for bridge repair, rehabilitation, replacement, and new construction demonstrating the application of innovative design, materials, and construction methods.
• The Congestion and Air Quality Improvement Program, provides flexible funding for Regional and local governments for transportation projects and programs to reduce congestion and improve air quality, focusing on ozone, carbon monoxide, and particulate matter.
  • It included the Diesel and Alternative Fuel Program, providing funds to Regions and local authorities to reduce emissions by fossil fuel phaseout.
  • It included the Traffic Flow Improvement Program, provides funds to Regions and local authorities to improve traffic flow and shift travel demand.
• The National Culvert Program, provides funding for Regions and local governments to replace, remove, and repair culverts or weirs.
• The Transportation Technologies and Innovation Program, provides grants to researchers to develop advanced transport technologies, as well as the deployment and operation of these systems.
• The Businesses and Enterprises Road Program, assists small and medium businesses (SMEs) with capacity building and improving competitiveness for highway facilities and contracting.
• The Road Tax Evasion Program, provides funding to Regions and local governments to support enforcement efforts and training, to reduce evasion on fuel duty and road tax.

Highway Construction Projects

The NHP includes three extension programs across Keltia and Alduria. This included:

1. The Pan-Keltia Expansion Program - Boriquén, working from the Pan-Keltian Highway Expansion Act, 1726, will expand the Pan-Keltian Highway through the new C59 between Castellón, Hato Rey, and Puerto Carrillo. This covers over 140 km of new dual-lane carriageway, with new three-lane ring roads at Hato Rey and Castellón. It will also connect with the C6 at Puerto Carrillo.
2. The Pan-Keltia Expansion Program - New Caputia, will expand the PKH through the new C76 between Ancash, Ravaillac, and Corcovado; and the new C67 between Junín, St. Melusine, and Corcovado. This covers over 160 km of new dual-lane carriageway, with new three-lane ring roads at Ravaillac, St. Melusine, and Corcovado.
3. The Pan-Euran Extension Program, will expand the Pan-Euran Highway through the new C19 between Corrada del Río to Villalba, with more than 100 km of new dual-lane carriageway, with a new three-lane ring road at Siwa. It also covers new three-lane ring roads at Amapola and Villalba.

Rail

The Railways Strategy, made in collaboration with Nouvelle Alexandrie Railways built upon the success of the Keltian High Speed and Aldurian High Speed, as well as creating dedicated rail networks for the Islands regions. It represents €85 billion of investment, from high-speed rail to freight services, across 4 programs:

• The Alte Velocidad Vision 1740, is the official funding vessel to cover the construction, rolling stock, and maintenance of the Alte Velocidad Vision 1740, the official NAR project program for the inauguration of 5 new high-speed lines by 1740.
  • It called for the creation of three new lines in Keltia, one in Alduria, and one in Lyrica; a total of 1,130 km of new double, electrified track.
  • It called for negotiations with Constancia on the expansion of high-speed networks cross-border, to Astérapolis and Port Aguilar.
• The Consolidated Freight Rail Grant Program, provides funds for projects to bring new freight services, expand existing services, and improve the safety, efficiency, and reliability of freight rail. This includes funding for railroad crossing elimination projects, repair and procuring of rolling stock, and (re-)construction of freight facilities.
  • It included the National Safety and Reliability Program, to enhance and upgrade the safety and reliability of the national freight network; over four sub-programs:
    • The Technology Adoption and Automation Program;
    • The Track Realignment and Signaling Program;
    • The Grade Separation and Track-Dualling Program; and
    • The Safety Training Program.
  • It included the Freight Yards & Intermodal Terminal Program, worth €2.2 billion, to construct and upgrade freight yards and intermodal terminal facilities; divided over two sub-programs:
    • The Harbor Intermodal Program; and
    • The Industrial Estate Freight Yards Program.
  • It included the Next-Gen Freightliner Program, to research and develop a new generation of freight trains; including specialisation of rolling stock.
• The Federal-Regional Passenger Rail Grant Program, provides for projects that support maintenance and repair of rolling stock and facilities; improve performance and efficiency; or expand or establish new intercity passenger rail service; further divided into two categories: (1) interregional rail, and (2) interurban rail.
  • It included the Transforming Rail Program, providing funding for enhancing existing corridors through right-of-way acquisitions, final design, and construction activities; as well as bridge replacement and addition of tracks.
  • It included the New Corridors Program, providing funding for creating new standard-gauge railways across the nation; focusing specifically on the Islands regions.
  • It included the ExpresoReg Program, providing funding for track expansion, construction of stations, and resignaling of ExpresoReg services; the interurban category for NAR services.
• The Restoration and Enhancement Program, provides funding and technical assistance for projects to initiate, restore, or enhance rural passenger rail service.
  • It included the Rural Railways Enhancement Program, to enhance and modernize rural railways services, including both long-distance (sleeper) and rural-only trains; over two sub-programs:
    • The Rural Networks Program; and
    • The Country to City Connectivity Program.
  • It included the Restoring Rail Service Program, the federal program to restore intercity passenger and freight rail services on closed lines, as well as modernizing current branch lines with track doubling, electrification, and grade separation work; over three sub-programs:
    • The Service Restoration Program;
    • the Branch Integration Program; and
    • The On-board Services Program.
• It also included other programs, under €100 million in funding each:
  • The Railway-Highway Crossings Safety Program, supports projects with the goal of reducing the number of fatalities, injuries, and crashes at public railway-highway grade crossings.
  • The High-Density Regions and Areas Formula, an additional formula funding component that is added to provide administrations with additional financial assistance for planning, final design, expertise-building, and operational assistance.
  • The Statistics Program, providing funding to run projects for statistics on transportation economics, railway activity, intermodal freight activity, and commercial railway service, and providing context to decision makers and the public for understanding statistics on transportation.
  • The Training and Education Program, provides resources for the development and delivery of technical assistance, training, professional development, and education programs to improve the professional capacity of the workforce that manages, develops and maintains the national railways system.
  • The Technology and Innovation Deployment Program, providing funding to advance research products into proven technologies and demonstrated practices; identify the market forces that will influence successful technology and innovation deployment; and plan and deliver effective technical assistance, training, communication and outreach to promote rapid adoption of proven, market-ready technologies and innovations.
  • The Prioritisation Process Pilot Porgram, to award grants to selected Regions and City Planning Organizations to fund the development and implementation of publicly accessible, transparent prioritization processes to assess and score projects according to locally determined priorities, and to use such evaluations to inform the selection of projects to include in transportation plans.

High Speed Rail

Map of the planned high-speed network of Nouvelle Alexandrie by 1740 NA.

The AV Vision 1740 envisions the construction, inauguration, and operation of five new corridors by 1740 AN.

1. The AV Costa a Costa or C2C, is a program to create a new corridor between Wechuahuasi, Cárdenas, Hato Rey and Puerto Carrillo. This 400 km double, electrified track will be made available for 320 km/h. It will utilize the Cárdenas Tunnel, and share about 15 km of track with AVK. Major infrastructure projects include the 6 km-long Tunnel de Lajas, and a second Morano rail bridge at Potosí. The project will open in two phases: the first phase, between Wechuahuasi and Castellon, will open as early as 1734; the second phase, between Castellon and Puerto Carrillo, via Hato Rey, will open in 1740.
2. The AV A Campo Traviesa (AVACT), is a program to create a new corridor between Punta Santiago, Carillo, Vilalba, and Kerman. This 280 km double, electrified track will be made available for 320 km/h. It will start in Punta Santiago, where the AVA will be quadrupled. Major infrastructure projects include the massive Porte de Asuara, west of Carrillo, crossing the Asuara river on a major new bridge; and the 4 km-long Tunnel de Husaz. The project will open in two phases: the first phase between Punta Santiago and Carrillo, will open in 1735; with phase two, between Carillo and Kerman opening in 1740.
3. The AV Lyrica, is a program to create a dedicated high-speed rail corridor in Lyrica, between Beaufort and Lausanne. This 180 km double, electrified track will be made available for 320 km/h. Additional stops will be furnished at Montchèry and Carrasquillo. Major infrastructure projects include the Porte de Mailly northeast of Carrasquillo. It will open in 1734.
4. The AV New Caputia, is program to create a dedicated high-speed rail corridor in New Caputia, connecting with AVK at San Luis. Stops will be created at Ravaillac and Corcovado. This 120 km double, electrified track will be made available for 320 km/h. Major infrastructure projects include the 4 km-long Túnel de Monterrey. It will open in 1734.
5. The AV Valencia, is a program to create a dedicated high-speed corridor in Valencia, connecting with the AVK at Santiago. Stops will be created at Trévoux and Chambéry. This 80 km double, electrified track will be made available for 320 km/h. Major infrastructure projects include the 3 km-long Túnel de Saint-Cloud and the 6 km-long Túnel del Portal de Valencia. The latter will carry the AVV underneath the dense northern Chambéry conglomeration, bypassing the Pornadé Curve. It will open in 1734.

It also included the upgrade and expansion of the existing high-speed lines:

1. The AV Keltia Upgrade Program, is a program to improve connectivity on the AVK between Cárdenas, Rimarima, San Luis, and Parap. This includes regrading the section between Roanne and Parap, making it available for 320 km/h, raising it from the current 270 km/h. Creating a new regional station, Monte Real, east of Ciudad Real, with through tracks for express trains. Constructing two new deep-level tunnels on the outside of the Cárdenas Tunnel, separating it from the Airport Express Train. And the quadrupling north of Rimarima, including with a flying junction, separating the AV Oeste from AV Keltia.
2. The AV Alduria Phase 2, is program to extend the current terminus beyond Amapola and towards Alkhiva via Tudela. This 70 km double, electrified track will be made capable of 320 km/h. Other parts of the project include the construction of the Porte de Gramercy station south of Gramercy, improving connectivity in the region, with through tracks for express trains. As well as regrading the Narbonne-Punta Santiago track to 320 km/h, up from the current 290 km/h.

Commuter Rail

The New Corridors Networks called for the creation of three new railways:

1. The Isles of Caputia Railway, is program creating a standard-gauge railway on the Isles of Caputia, between Gotfriedplatz and Seydlitz. The track will be double and electrified. Further stops will be constructed in Ulrichstadt and Velez. A depot will be constructed at Velez.
2. The New Luthoria Railway, is a program to upgrade the current meter-gauge heritage line between New Luthoria City, Rochefort, and Pharos to standard-gauge track. It will also be doubled. A new depot will furthermore be constructed in Rochefort.
3. The Islas de La Libertad Railway, is a program creating a standard-gauge railway on the Islas de la Libertad, between Nuevo Corcovado and Ciudad de Howard. The track will be double. Further stops will be constructed in Dorado and San Lorenzo. A depot will be constructed at Ciudad de Howard.

The ExpresoReg Program called for the creation of five new networks:

1. The Napoléon ExpresoReg Program, is a program to create new tracks in Punta Santiago and Narbonne, creating a new interurban service for West Alduria. It includes the construction of six new stations, as well as quadrupling of tracks, allowing for dedicated separated tracks.
2. The Kuntisuyu ExpresoReg Program, is a program to create new tracks in Parap, Huancaveliva, and Huichajanca, creating a new interurban service for East Wechua. It includes the construction of four stations, as well as quadrupling of tracks, allowing for dedicated separated tracks.
3. The Boriquén ExpresoReg Program, is a program to create new tracks in Hato Rey, Dorado, Alaia, Yabucoa, Vela, Carolina, and Minillas, creating new interurban services throughout Boriquén. This includes the construction of sixteen new stations, new branch lines, and quadrupling of tracks, allowing for dedicated separated tracks.
4. The País Real ExpresoReg Program, is a program to create new tracks in Potosí, Ciudad Real, Lajas, Wechuahuasi, and Jirishanca, creating new orbital routes around Cárdenas and interurban services for West Santander. This includes the construction of eight new stations, and quadrupling of tracks, allowing for dedicated separated tracks.
5. The Mailly ExpresoReg Program, is a program to create new tracks in Lausanne, Guayama, Carrasquillo, and Gálatas, creating new interburban services for West South Lyrica. This includes the construction of ten stations, and quadrupling of tracks, allowing for dedicated separated tracks.

Airports

The Airports Strategy built upon the sucess of Cárdenas International Airport and Punta Santiago International Airport, as well as Lausanne Airport and Parap Airport. It represents over €18 billion of investment, from infrastructure to environmental standars, over three programs:

• The Airport Infrastructure Program, worth program, providing funding to public agencies, private entities, Regions, and local authorities owning a public use airport. These include Primary airports, certain cargo airports, and most general aviation/commercial service airports that are not primary airports but part of the national airport network. This amounts to over 1,800 airports. The funds are divided into three parts: (1) Primary Allocation, for runways, taxiways, and terminal buildings, including airport-transit connections and roadways; (2) Non-primary Allocation, for projects of noise reduction, safety and sustainability, and multimodal facilities; and (3) Contract Towers. The latter will be furnished with a dedicated €250 million.
• The Facilities and Equipment Program, providing funding for Federal-airport sustainment work and facilities and for replacing Federal-owned terminal and rout air traffic control facilities; improvement of air route and terminal facilities; workplace safety and environmental standards compliance; Federal-owned fuel storage tank replacement and management; unstaffed infrastructure sustainment; real property disposition; electrical power system sustain and support; energy maintenance and compliance; hazardous materials management and environmental cleanup; facility security risk management; cyber risk management; mobile asset management program; and administrative expenses, including salaries and expenses, administration, and oversight.
• The Airport Terminal Program, providing grants to eligible airports for capital improvements for airport terminal development generally defined as development of an airport passenger terminal building, including terminal gates; access roads servicing exclusively airport traffic that leads directly to or from an airport passenger terminal building; walkways that lead directly to or from an airport passenger terminal building; multimodal terminal development; and projects for on-airport rail access projects. As well as projects for relocating, reconstructing, repairing or improving an airport-owned airport traffic control tower.

Waterways and Ports

The Ports and Waterways Strategy built upon the success of Punta Santiago Port, Port of Jirishanca, and Beaufort Port. It represents €12.9 billion of investment, from water resources to ports customs, over seven programs:

• The Federal Port Infrastructure Development Program, is the federal funding program providing support for modernization and expansion of ports to remove bottlenecks, ensure long-term competitiveness, and promote resilience, cybersecurity, and sustainability.
• The Water Resources Operation, Remediation, and Development Program, provides support for Regions and local governments to fund inspection, operation, maintenance and related activities for waterways. This includes navigation channels, locks and dams, flood defenses, and multi-purpose infrastructure.
• The River and Coast Rehabilitation and Enhancement Program, provides funds to construct and upgrade coastal and inland navigable waters, including widening and deepening projects.
• The Ferry Ports Program, provides funds to businesses to provide ferry services, linking highways, and providing vital connections on the Islands Regions.
• The Port Customs Modernization Program, provides funding for constructing, expanding, sustaining, and upgrading land ports of entry, as well as for border security operations.
• The Port Emission Reduction Grant Program, provides funding for ports to reduce truck idling and emissions, including through port electrification.
• The Coastal Infrastructure, Navigational, and Design Program, providing funding for procurement, construction, and improvement to address coastal facility infrastructure and housing construction, replacement, upgrade or improvement needs; construction and improvements to buoys and structures assisting navigation on waterways; and survey and design required for future year projects.

Public Transportation

The Public Transport Strategy built upon the success of the Cárdenas Metro, Punta Santiago Metro, and Parap MetroRail System. It represents over €62.4 billion in investments, for metros, trams, buses, and other public transportation modes, over seven programs:

• The Urban Area Formula Grant Program, is the federal funding program that supports and invests in public transport networks in areas with a population above 50,000 people, including planning and operating assistance.
  • It included the Urban New Networks Grant Program, providing funding for the creation and maintenance of new networks and expansion of existing infrastructure. This focuses on projects with significant environmental impacts, complicated financial arrangements, and complex engineering and design elements. The application also involved an extensive engineering phase with planning and final design.
  • It included the Urban Small Neworks Grant Program, providing funding for the creation and maintenance of networks that are individually below €400 million in investments. It focuses on projects that work at a local level, utilizing limited land use change. The difference in application means that Small Network one phase in advance of receipt of a construction grant; foregoing engineering planning and final design.
  • It included the Core Capacity Grant Program, funding the expansion of existing corridors to handle increased demand. This includes rehabilitation and replacement of rolling stock, track, line equipment, and structures, signals and communications, power equipment and substations, passenger stations and terminals, security equipment and systems, maintenance facilities and equipment, administration buildings, support vehicles, and operational support equipment (including computer hardware and software). It can also include preventative maintenance and the development and implementation of a transit asset management plan. Projects may not include expenditures that are needed for new or expanded service.
  • It included the Stations Accesibility Program, funding projects to remove rail and bus station barriers to access for persons with disabilities. This includes the creation of step-free access facilities, ramps, and guide pavement.
• The National Transit Capital Investment Program, provides funding for capital investments in heavy rail, commuter rail, light rail, streetcars, and bus rapid transit.
• The Rural Transit Grant Program, funding Regions, subdivisions of Regions, and local authorities for transportation research, technical assistance, and related support services in rural public transportation. It also provides funding for the establishment and expansion of rural bus and related rural transportation networks. Lastly, it supports projects to develop information resources and real-time transit management and operations systems.
• The Bus and Bus Facilities Formula Grant Program, provides funding to replace, rehabilitate, purchase, or lease buses and bus related equipment; and to construct, rehabilitate, purchase, or lease bus-related facilities.
  • It included the Bus Grant Program, providing funding to Regions, Counties, Cities/Townships, and special districts, to replace, rehabilitate, purchase, or lease buses, vans, and bus related equipment to rehabilitate, purchase, construct, or lease bus-related facilities. It also includes projects for technological innovation and to reduce emissions at facilities. Of this, €100 million will be used for training programs.
  • It included the Low or No Emission Bus Grants Program, providing funding to Regions, Counties, Cities/Townships, and special districts, to purchase or lease of zero-emission and low-emission transit buses, including acquisition, construction, and leasing of required supporting facilitates. 2% (€20 million) of the funding for zero emission buses within this program will also support workforce development training so transit operators and mechanics can learn how to maintain and operate zero emission vehicles.
• The Transit-Oriented Development Cooperative Program, provides funding to local communities to integrate land use and transportation planning in urban development.
• The Public Transportation Workforce Development Program, provides funding to support workforce development and transition, as well as technical support for workforce training to transit providers.
• The University Transportation Research (UTR) Program, supporting activities for colleges and universities, and consortia thereof on research and development of technology and expertise in the many disciplines comprising transportation through education, solutions-oriented research and technology transfer, and the exploration and sharing of cutting-edge ideas and approaches.

Metro and Light Rail

The NTCI Program called for the creation of four new metros networks:

1. The Lausanne Metro, is a program to create a dedicated subway line for Lausanne, the capital of South Lyrica. This will be a 18 km, double, third-rail electrified line completely underground, serving the city center east-west with eight stations, connecting to the train station, with a possible extension to Lausanne Airport in the future. This will open by 1735.
2. The Narbonne Metro, is a program to create a dedicated subway line for Narbonne, the second city of Alduria. This will be a 12 km, double, third-rail electrified line mostly underground, serving the city center east west with fourteen stations, connecting to the train station, with an at-grade section to Narbonne Airport. Future expansion to Punta Santiago is possible. This will open in 1734.
3. The Potosí Metro, is a program to create a dedicated subway line for Potosí, the capital of Santander. This will be a 16 km, double, third-rail electrified line completely underground, serving the city center north-south with ten stations, connecting to the train station, with an underground section to Potosí Airport. This will open by 1735.
4. The Rimarima Metro, is a program to create a dedicated subway line for Rimarima, the second city of Wechua. This will be a 14 km, double, third-rail electrified line completely underground, serving the city center east-west with eight stations, connecting to the Rimarima Pueblo HS station.

And eighteen new light rail/streetcar networks:

1. The Alduria Light Rail Program, is a program funding four separate streetcar projects, for a total of six lines at 68 km in length:
   1. Line 5 of the Punta Santiago Streetcar
   2. The creation of the two-line Napoléon Regional Light Rail
   3. The creation of the single-line Aldemín Streetcar
   4. The creation of the two-line Beauharnais Streetcar
2. The Wechua Light Rail Program, is a program funding three separate streetcar projects, for a total of four lines at 22 km in length:
   1. The creation of the single-line Huancavelia Streetcar
   2. The creation of the single-line Judah Streetcar
   3. The creation of the two-line San Luis Streetcar
3. The Santander Light Rail Program, is a program funding three separate streetcar projects, for a total of four lines at 30 km in length:
   1. The creation of the two-line Potosí Streetcar
   2. The creation of the single-line Santiago Streetcar
   3. The creation of the single-line Castellón Streetcar
4. The Lyrica Light Rail Program, is a program funding two separate streetcar projects, for a total of three lines at 20 km in length:
   1. The creation of the two-line Beaufort Streetcar
   2. The creation of the single-line Lausanne Streetcar
5. The Chambèry Streetcar is a program creating a dedicated streetcar line at 8 km in length.
6. The Hato Rey Streetcar is a program creating a dedicated streetcar line at 8 km in length.

National Health Plan

The NHP was devised by the Department of Social Security and National Solidarity, along with the Department of Education, Department of Housing and Urban Development, and Department of Civil Works and Transportation. It outlines a comprehensive vision for top-class healthcare services, universal access, and breakthroughs in science and innovation. The planm focused on reducing waiting lists, improving patient care and outcomes, and moving towards a consolidated care experience with both health and social care. It was divided into four themes:

1. The Plan for Patients;
2. Medical Science and Innovation
3. Healthcare Infrastructure
4. Integration of Health and Social Care

It also included specific chapters on Dentistry and Midwifery.

Plan for Patients

The aim of this plan was provide high-quality, accessible, and patient-centred care that focuses on improving patient experience, reducing waiting times, and ensuring equitable access to healthcare services. By promoting shared decision-making and empowering patients, the Government sought to enhance the overall quality and safety of care.

Patient -Centred Care

The policies for improving patient outcomes and standards in healthcare are focused on empowering patients and their representatives to inform decisions and reforms.

• The Patient Experience Enhancement Initiative (PEEI), is a comprehensive program to improve patient experiences and outcomes, through the implementation of specific initiatives and regulations. The PEEI will be led by a multidisciplinary task force of healthcare professionals, patient advocates, researchers, and care experts. These will establish thorough PEEI Guidelines and Standards, focusing on best practices for patient-centred care, encompassing a wide variety of care aspects, including communication, care coordination, patient preferences, and physical environment. We will help Hospitals develop implementation plans for patient-centred care initiatives, from enhancing communications through training programs, documentation digitization, and the use of patient-friendly language; process optimization, resource allocation management, and appointment scheduling systems to reduce waiting lists; to enhancing physical environments through patient-friendly spaces, improved amenities, and patient-specific design. We will support collaboration and knowledge sharing between Hospital trusts participating in the PEEI. This includes funding regular workshops and conferences; as well as a dedicated online platform and knowledge hub. Through feedback systems and evaluation, the PEEI will continuously improve.
• The Shared Decision-Making Program (SDMP), will aid decision-making between healthcare professionals and patients, by making the latter an active participant. We will establish a work group of healthcare professionals and patient representatives. This group will develop training modules and resources for shared decision-making principles and communication. We will also introduce new decision aids and tools that assist patients in understanding their healthcare options, including through a central patient decision repository. We will also reform electronic health records systems and clinical decision support systems to integrate decision aids and tools, and enhance healthcare workflows. Through a robust monitoring and feedback system, the SDMP will be assessed on effectiveness and impact on patient outcomes and experiences. These include the development of data collection tools and data analysis to identify key areas for improvements and refinements.
• The Patient Feedback Mechanisms Development Program (PFMDP), will aid to establish effective tools and resources for collecting, analysing, and utilising feedback, to drive quality improvements in our healthcare. We will establish a new digital feedback platform, focusing on use-friendliness, and ensuring data privacy, confidentiality, and anonymity of patients. Through the development of advanced analytics tools, patterns, trends, and common themes in patient feedback can be identified and addressed through regular reporting, highlighting areas of improvement and sharing best practices among healthcare professionals. With this, we will fund new Quality Improvement Initiatives, developing targeted improvement strategies, action plans, and performance indicators to address identified issues and enhance patient experience. These QIIs will be a collaborative effort between healthcare professionals, patient representatives, researchers, and care experts. They will also include training programs and resources focusing on patient feedback, to enhance communication and empathy skills. Through guidance, we can implement changes within healthcare settings based on patient feedback.
• The Patient Advocacy and Support Fund (PASF) will go towards three initiatives: establishing new patient advocacy programs and recruiting and training patient advocates to provide support, guidance, and information to patients; developing education programs to enhance health literacy and establishing peer support networks where patients can connect to others with similar health challenges, empowering patients to actively participate in their care; and conducting regular assessments of the effectiveness and impact of patient advocacy, including through patient satisfaction surveys. We will foster collaboration between healthcare providers, patient advocacy groups, and relevant stakeholders to maximise the impact of PASF.
• The Patient Engagement in Healthcare Design Program (PEHD) will ensure that patients and their representatives have an active say in the design of healthcare facilities, focusing on their needs, preferences, and comfort. We will establish design committees that include healthcare providers, patient representatives, architects, and facility managers. These committees will conduct thorough surveys and focus groups studies to gather patient perspectives on facility design, accessibility, and patient amenities. They will especially focus on important factors such as ease of navigation, comfort, privacy, cleanliness, noise levels, and access to natural light and air. Special attention will be given to utilise technology to streamline patient flow and communication, including through digitisation. A comprehensive needs assessment will identify areas of improvement and prioritise patient-centred modifications. With analytics tools, common themes and concerns can be identified to implement thorough action plans that inform design decisions throughout the medical organisation.

Accessible and Timely Care

The Government remains committed to the promise to provide quality healthcare on time, ensuring universal access. Our policies will work to continue to reduce waiting times, reduce health inequalities, and ensure access to healthcare for all.

Reducing Waiting Times

• The Faster Access Initiative (FAI) will reduce waiting times for primary care appointments, specialist referrals, and elective procedures. We will establish a multidisciplinary task force including healthcare professionals, patient representatives, researchers, and relevant stakeholders, to identify and set specific performance targets for different healthcare services, based on evidence-based guidelines and best practices. Through new incentives for healthcare providers, such as financial bonuses, recognition, and professional development opportunities, these performance targets will be ambitious yet realistic, and aimed to significantly reduce waiting times. The most important part of the FAI is the workforce expansion programme. We will recruit and train additional healthcare professionals, focusing on GPs, nurses, and support staff, to enhance capacity and meet increased demand for services. This will be done through new recruitment campaigns and financial incentives, including college fees grants, loan forgiveness programs, and signup bonuses. The taskforce will conduct a comprehensive review of existing processes to identify bottlenecks, and implement process improvement strategies to streamline workflows, reduce administrative burdens, and optimise resource allocation. We will also foster increased collaboration and communication between primary and secondary care services, establishing new care pathways and referral processes to streamline transition. We will also facilitate shared decision-making and coordination of care through multidisciplinary team workshops and conferences, as well as webinars and a dedicated online platform.
• The Booking System Improvement Program (BSIP) will enhance booking and scheduling systems across healthcare settings. We will fund initiatives to upgrade existing booking and scheduling systems, enhancing system functionality, user interfaces, and integration with other healthcare IT systems, with a specific focus on scalability and adaptability to future needs. We will also establish new centralised and regional coordinated systems to manage appointments and optimise resource allocation for entire Hospital Trusts at once, as well as between Trusts. We will also develop standardised protocols and guidelines for appointment booking and scheduling, defining appointment durations, follow-up intervals, and referral criteria to streamline booking. We will ensure these protocols are consistent and transparent for patients, and publicly available. Training programs will also ensure that support staff and healthcare professionals are effective on appointment management and system usage.
• The Outpatient Pathway Program (OPP) will improve outpatient services and enhance patient experience. The OPP will be used to fund the development of IT infrastructure, including electronic health record systems, secure and reliable telemedicine platforms and virtual consultations, and upgrading of networks and cybersecurity measures. We will establish multidisciplinary team meetings to discuss complex cases, treatment plans, and care coordination, including through secure messaging platforms and virtual meeting tools. We will establish new virtual clinics with video conferencing software and remote monitoring devices, such as the Smart Pacemaker. Through training programs, we will ensure healthcare professionals are skilled to conduct virtual consultations and make virtual appointments.

Tackling Health Inequalities

• The Health Equity Fund (HEF) will address health inequalities and ensure equal access to healthcare. The HEF will be administered by a dedicated task force that includes healthcare professionals, patient representatives, local authorities officials, and community organisations. A comprehensive assessment will identify specific healthcare needs and barriers to access in socioeconomically disadvantaged areas, with specific focus on rural areas. Targeted interventions such as health promotion campaigns, preventive care initiatives, and disease management programs will be developed to tailor to identified needs. We will also support outreach programs in collaboration with community organisations, faith-based groups, and local authorities. This includes sensitive health education initiatives. We will also invest in language services such as interpreter services and translated materials; transport solutions to ensure access to healthcare for remote communities; and awareness campaigns to ensure patients are informed about available services, as well as their rights and entitlements. The HEF will also support initiatives that offer screenings, vaccinations, and health promotion activities to specific needs of disadvantaged communities.
• The Health Navigator Program (HNP) will be a groundbreaking effort to improve patient experiences and outcomes. It will train a new team of health navigators from diverse backgrounds, including social workers, community health workers, and nurses. These navigators will be deployed in areas of high health inequalities, aiding patients directly with navigating the healthcare systems. This includes assistance in accessing appropriate healthcare services, understanding treatment plans, and removing barriers to care. By collaborating with primary care providers and community organisations, these navigators will be integrated with existing care teams, providing a vital service to patients.

Quality and Safety

The government wants to keep patients safe and maintain the high standards required from a modern healthcare institution.

• The Quality Assurance Framework (QAF) will define minimum standards that healthcare professionals must meet to ensure the delivery of safe and high-quality care, encompassing important aspects such as patient safety, clinical effectiveness, patient experience, and governance. It will also identify and promote best practices and evidence-based approaches and strategies that lead to improved patient outcomes, through extensive research, consultation with experts, and benchmarking against both national and international standards. Through a comprehensive and standardised set of quality indicators and metrics, consistency and fair comparisons and benchmarking across healthcare institutions can be assured. These indicators will include various aspects of care, including patient safety incidents, mortality rates, infection rates, readmission rates, waiting times, patient satisfaction, and adherence to clinical guidelines. We will establish support mechanisms to provide guidance, resources, and training to healthcare professionals in meeting quality standards. We will also foster collaboration between healthcare professionals, regulatory bodies, professional organisations, and patients representatives to improve the QAF. Regular inspection, auditing, and feedback mechanisms will be used to refine the framework, and inform improvement plans and corrective actions.
• The Clinical Governance Program (CGP) will establish comprehensive clinical governance systems in healthcare facilities. We will encourage them to appoint clinical leaders who focus on quality improvement and patient safety initiatives, and empower them to engage with frontline staff. We will implement robust clinical audit programs to review and evaluate clinical practice against established standards, which will identify areas for improvement and ensure compliance with quality standards. We will encourage the development of risk management strategies to identify, assess, and mitigate risks to patient safety, as well as establishing incident reporting systems and mechanisms for learning from adverse outcomes. We will also foster collaboration between primary carers, specialists, and nurses to ensure a holistic and comprehensive approach to patient care, ensuring clinician participation in decision-making. We will also develop new evidence-based clinical guidelines and care pathways & transitions that involve input from frontline clinicians, professional organisations, and expert groups, to ensure relevance and clinical ownership. We will also support the use of clinical decision support tools and resources to facilitate access to up-to-date evidence and guidelines at the point of care.

Prevention and Health Promotion

The Government believes that preventing disease or illness is better than curing it. That is why we are focusing on implementing policies and programs for prevention and health promotion, reducing the pressure on healthcare and improving public health.

• The National Healthy Living Campaign (NA Health Life) will raise awareness about preventable diseases and promote healthy lifestyles. They include dedicated multimedia campaigns tailored towards various public health issues, including smoking-cessation, alcohol and substance abuse, obesity, burn-out prevention, and anti-social behaviour. We will conduct extensive research to understand target audiences’ demographics, preferences, and health behaviours, focusing on specific messaging for different age groups, ethnicities, and socioeconomic backgrounds. We will engage with health experts, community organisations, and researchers to provide evidence-based information for the campaign and leverage their expertise and grassroots networks. We will especially establish a strong presence on social media platforms, encouraging interaction with users. We will conduct pre- and post-campaign surveys to assess changes in knowledge, attitudes, and behaviours related to preventable diseases and healthy lifestyles. We will also implement feedback mechanisms for target audiences. We will use this information, as well as long-term trends, to continuously refine and improve the campaign.
• The Early Detection and Screening Programs (EDSP) include two national programs: the Cancer Screening Program; and the Cardiovascular Screening Program. For the former, we will implement population-based screening programs for breast, cervical, and colorectal cancers. For this, we will establish new screening centres and mobile units; as well as closing partnerships with primary care providers for delivery of services. We will also develop comprehensive communication strategies to inform the public about the benefits and process of screening. And we will ensure that funding is available for diagnostic tests and follow-up care for patients with positive screening results, including mental care services. For the latter, we will offer cardiovascular risk assessments, including blood pressure checks, cholesterol testing, and lifestyle counselling. We will establish screening clinics in primary care facilities and community centres to accomplish this.
• The School Health Education Initiative (SHEI) will develop age-appropriate health education materials in collaboration with health experts, teachers, and curriculum developers. These will cover various health topics, including nutrition, physical activity, mental health, sexual health, and substance abuse prevention. The materials will take diverse needs of students, such as cultural sensitivity, inclusivity, and gender appropriateness, into account. We will develop standardised training programs and professional development opportunities for teachers to enhance their knowledge and skills in health education. We will also develop interactive teaching methods, such as group discussions, role-playing, and multimedia presentations to help teachers to engage with students. We will collaborate with school administrators to implement healthy school environments; including by supporting nutritious food options in school cafeterias; implementing PE activities including recess breaks and extracurricular sports clubs; and providing guidelines for managing chronic health conditions in schools, ensuring proper support and accommodations for SEND students. We will also support the establishment of partnerships between schools and local sports clubs to provide opportunities for low-cost sports activities outside of school. We will encourage inviting healthcare professionals to deliver guest lectures and workshops on health topics; and facilitating field trips to public health exhibitions and healthcare facilities.

Self-Care

We want to empower citizens to take responsibility for their own health and well-being. This will reduce waiting times, lower hospital admissions, and reduce pressure on primary carers.

• We will launch a National Self-Care Awareness (NSCA) campaign will promote self care and raise awareness about the benefits. We will collaborate with healthcare providers, local authorities, researchers, and community organisations to create information, resources, and tools to promote positive lifestyle changes and adopt preventive measures. The campaign will have a multimedia approach, with targeted campaigns for different age groups and demographics. It will also include workshops, seminars, and health fairs to engage with communities to learn about self-care practices and interact with healthcare professionals. We will regularly evaluate the campaign and establish feedback mechanisms to adapt to changing demographics and public health behaviour.
• The Self-Care Information Hub (SCIH) will provide evidence-based resources and tools on the different aspects of self-care. We will collaborate with academia, healthcare professionals, policymakers, and software developers to aggregate information, ensuring accuracy, relevance, and suitability for diverse user groups. This includes information on nutrition, physical activity, stress management, sleep hygiene, mindfulness, and self-assessment tools. We will ensure the platform is designed to be user-friendly, responsive and optimised for various devices. It will include interactive tools and features for self-assessment, goal-setting modules, and personalised health planning. This includes accessibility for other languages and specific features for individuals with disabilities. We will evaluate the platform through several key performance indicators such as number of unique visitors, user engagement metrics, user satisfaction surveys, and the impact on self-care practices and health outcomes. This will inform adjustments and improvements to the platform.

Medical Science and Innovation

The Government is driven by the vision of advancing medical science and fostering innovation within the healthcare system. We have made a lot of progress over the last decade, and the Government wants to capitalise on that success. The aim is to invest in new research and development, promote the commercialization and adoption of new technologies and methodologies, and support ongoing training and education for healthcare professionals. Embracing cutting-edge advancement, we want to improve patient outcomes, personalise medicine, drive progress in addressing emerging healthcare challenges, and end the scourge of the deadliest diseases.

Research and Development

Our plan for medical research is focused on driving innovation and scientific discovery, to force breakthroughs in vital fields, meeting medical needs, and combating emerging healthcare challenges.

• The National Medical Research Fund (NMRF) will support innovative research projects, and accelerate scientific discovery, promote medical innovation, and improve patient outcomes. The fund will be issued through grants and dedicated funding opportunities for researchers in academia, industry, and hospitals, spread across seven different program fields (see table). This includes different grant categories, from seed grants, project grants, career development grants, and collaborative research grants. For this, a rigorous peer review system, utilising expert review panels of leading researchers, healthcare professionals, and industrial experts, will be implemented to evaluate grant applications based on scientific merit, feasibility, and potential impact. These expert boards will also conduct comprehensive reviews to identify priority areas, and establish targeted funding streams. These include chronic diseases, mental health, ageing population, infectious diseases, and personalised medicine. Through regular reporting requirements and a feedback mechanism, the progress and outcomes of research can be monitored. Regular impact assessments will evaluate the contribution of NMRF to scientific discovery, knowledge translation, and healthcare innovation. We will also work on long-term strategies of the fund to supplement it with additional funding sources such as donations, public-private partnerships, and industry collaborations.
• The Collaborative Research Consortia (CRC) will bring together researchers, clinicians, academia, industry experts, and healthcare professionals. These CRCs will conduct systematic assessments of healthcare priorities and unmet medical needs in their respective areas, by considering disease prevalence, burden on healthcare services, potential for breakthroughs, and alignment with national health priorities. They will furthermore facilitate regular knowledge exchange platforms through conferences and workshops, with a focus on interdisciplinary collaboration, sharing technical know-how, resources, and insights to accelerate translation of research into practical applications. CRCs will also include a dedicated Technology Translation and Commercialisation Unit, who will provide assistance with IP protection, business development, and access to funding for product development and commercialisation. They will also be encouraged to develop long-term plans to foster continuity and impactful research collaboration.

New Technologies

Our plans for hospitals include the adoption of cutting-edge technologies, including the continuation of digitisation.

• The Technology Assessment and Evaluation Framework (TAEF) will establish an expert panel of healthcare professionals, researchers, economists, industry experts, and patient representatives. They will conduct a rigorous assessment of existing and new healthcare technologies, drugs, and treatments; establish safety profiles through analysis of pre-clinical and clinical trial data, monitoring adverse outcomes, and considering long-term safety implications; evaluate efficacy and effectiveness of interventions based on robust evidence, through clinical trial data, comparative effectiveness studies, real-world evidence, and meta-analysis; and establish cost-effectiveness analyses to evaluate economic impact of new technologies, through analysis of direct healthcare costs, cost savings, patient outcomes, and the overall value for money. The TAEF will establish evidence-based recommendations on the adoption of new medical technologies, drugs, and treatments to inform healthcare policy and decision-making; communicated through comprehensive reports, summarising the findings of assessments, the level of confidence in the evidence, and the potential benefits and risks associated with reviewed technologies. We will ensure that TAEF remains transparent through regular reporting and recommendation. It will be regularly updated and revised based on new evidence, technological advancements, and changes in clinical practice.
• The Digital Health Technology Program (DHTP) will promote the widespread implementation and adoption of digital health solutions. It focuses on enhancing patient care coordination and outcomes, and increasing digital literacy skills of healthcare professionals. The program will be implemented on a grant-based basis, which will assist in covering the costs of adopting and deploying digital technology. It will also offer technical assistance, providing guidance on digital health solutions, configuring systems, and interoperability between different technologies. DHTP will have specific funding for the implementation of the following three technologies: the adoption of electronic health records, and transitioning from paper-based records to digital systems; adopting remote monitoring devices, such as wearable sensors and home monitoring kits, allowing remote monitoring of patients’ vital signs, activity levels, and other health indicators; and the use of digital tools for care coordination, including secure messaging platforms, virtual care platforms, and shared care plans. We will also create training and education programs to increase digital literacy of healthcare professionals.
• The Technology Adoption Fund (TAF), will incentivize healthcare organisations to adopt technologies by providing financial support. This funding will be done on a grant-based program, covering costs for acquiring technologies, implementing it within healthcare settings, and providing training to healthcare professionals. The fund focuses on approved technologies that have undergone rigorous evaluation and meet criteria regarding safety, efficacy, and value for money. The grants cover medical devices, diagnostic tools, software applications, and innovative treatment modalities. We will encourage collaboration between healthcare providers, technologists, and other stakeholders, to share their experiences and lessons learned, as well as promoting shared proposals and use of technologies. We will also consider the potential for scaling and sustainability of technologies, by highlighting projects that integrate into existing healthcare systems, demonstrate long-term benefits, and have the potential for wider implementation.

Workforce Training and Upskilling

We want to invest in the continuous professional development of healthcare professionals, providing them with the necessary skills to leverage new technologies and advancements.

• The Professional Development in Healthcare Initiative (PDHI) will support healthcare professionals in acquiring new skills and knowledge. The program will provide financial support for training programs, conferences, and workshops, prioritising emerging healthcare needs and continuous professional development. Through comprehensive needs assessment on an individual and organisational basis, the workforce can be upskilled to address the most pressing educational needs on a local and national level. This includes a focus on personalised medicine, genomics, digital health, and AI. We will collaborate with educational institutions, training organisations, and industry leaders to develop and deliver high-quality programs, emphasising hands-on practical training, case studies, and interactive learning methodologies. We will implement a feedback mechanism and robust evaluation system to improve the program’s quality and relevance to meet the evolving needs of the workforce.
• The Research-Practice Integration Initiative (RPII) will foster collaboration between academia and healthcare providers. The RPII will facilitate the development of joint research programs between researchers and healthcare professionals, focusing on projects that have direct relevance to clinical practice, patient outcomes, and healthcare system improvement. We will also support regular knowledge-sharing forums and conferences with input from healthcare professionals, researchers, and policymakers to foster interdisciplinary dialogue. The RPII will also establish mentorship programs for early-career healthcare professionals to engage in research activities, gaining skills in methodologies, data analysis, and evidence-based decision-making. We will also develop mechanisms to translate research applications into new healthcare methodologies, developing clinical guidelines and protocols based on latest research evidence.
• The Continuing Medical Education (CME) Scholarships will support healthcare professionals in pursuing advanced training, specialisation, and certification. This scholarship will provide financial support to cover tuition fees, course materials, travel expenses (if applicable), and other associated costs for the chosen training or certification program. We will establish mentorships for recipients to provide support for professional development goals, monitoring progress, and advising on career advancement opportunities. A thorough framework will be established to establish a curriculum emphasis encompassing evidence-based medicine, critical appraisal, research methodologies, data analysis, and study design. We will incorporate ethical considerations in the curriculum, emphasising patient autonomy, informed consent, and ethical decision-making. We will establish reporting mechanisms to monitor attendance, completion of coursework, and any additional achievements or contributions made by recipients, providing updates on their progress throughout the programme. We will also conduct periodic evaluations to assess the impact of scholarships on healthcare professionals’ knowledge, skills, and career development. A strong feedback mechanism will identify areas for improvement and adjustment.
• The Interdisciplinary Collaboration Platform (ICP) will promote interdisciplinary collaboration among healthcare professionals. The program will establish new interdisciplinary teams that consist of professionals from various specialisations, as well as nurses, pharmacists, social workers, and administrative staff. These teams will conduct thorough assessments of patient needs, with a focus on addressing complex and multifaceted healthcare challenges. Each team will designate a leader and facilitators to coordinate and guide team efforts. We will provide training and support to team leaders for group management and collaborative activities, supporting regular team meetings, case discussions, and collaborative treatment plans. For this, we will encourage the use of technology to facilitate virtual meetings and communication, especially in geographically dispersed settings. We will establish a dedicated online platform, as well as hold conferences, to facilitate information sharing between teams.

Healthcare Infrastructure

The vision of the Government is to strengthen our healthcare infrastructure to support the delivery of high-quality care. We will work to secure adequate funding and resources to improve facilities, equipment, and the overall healthcare environment. We will also place an emphasis on the digital transformation of healthcare by the adoption of new IT systems and enhanced cybersecurity measures. Our investments in infrastructure and facilities will work to optimise resource allocation, enhance access to healthcare, and ensure a seamless, high-tech, and efficient healthcare system. By modernising our infrastructure, we also reduce operating costs of buildings and vehicles, which can ensure that budgets for hospitals and clinics focus on patients and staff.

Facilities Expansion and Mobile Healthcare

We will put a significant focus on enhancing healthcare facilities to provide modern and efficient healthcare services to patients across the nations. We will invest in upgrading and expanding our healthcare infrastructure networks.

• The Healthcare Infrastructure Enhancement Program (HIEP) will modernise and upgrade existing healthcare facilities. We will establish a thorough resource allocation framework to ensure fair distribution of funds, taking into consideration population size, healthcare needs, and the condition of current facilities. We will conduct rigorous priority assessments, in collaboration with directors, architects, industrial experts, and policymakers, to identify facilities that require immediate modernisation and upgrades, taking into consideration factors such as the age of the infrastructure, condition of equipment and facilities, patient capacity, and compliance with modern standards. These assessments will also specifically address infrastructural challenges in underserved or economically disadvantaged areas. We will require Hospital facilities to develop detailed infrastructure improvement plans that outline specific areas and facilities targeted for modernisation and upgrades, taking into account the long-term strategic goals of the Department. We will prioritise investments in modern medical equipment and technologies that enhance diagnostic capabilities and treatment options; including the adoption of digital healthcare solutions. The program will also allocate specific funding to improve patient rooms, waiting areas, and amenities to promote comfort and a welcoming environment, focusing on patient-centred improvements. It will also allocate specific funds for energy efficiency and reducing the carbon footprint of Hospital infrastructure, through renewable energy integration, energy-efficient lighting, and waste reduction efforts; which will reduce operating costs of the building, allowing more funds for patients and staff. Through regular evaluation, the outcomes achieved by the program in terms of improved patient care, safety, and overall healthcare quality are analysed, and the program can adapt accordingly.
• The Hospital Infrastructure Improvement Initiative (HI3) will address the critical need for construction and expansion of healthcare facilities. The program will conduct an in-depth assessment of healthcare facilities needs throughout the country. This will identify hospitals and clinics that require urgent improvements and expansions, as well as the needs of underserved and economically disadvantaged areas. A priority list of high-priority targets will be established, setting the initial focus of HI3. The program will allocate dedicated funds to undertake comprehensive refurbishment of identified high-priority hospitals, which will also target patient care areas, including wards, outpatient departments, and common areas. The program will also prioritise the construction and upgrading of state-of-the-art hospitals and clinics with advanced medical technology and equipment, which will adhere to stringent clinical practice standards and optimise workflow to enhance patient safety and outcomes. The program will allocate dedicated funding to expand and modernise emergency departments, improving triage systems, enhancing diagnostic capabilities, and streamlining patient flow as an integral part of the enhancements. It will also allocate specific funding for the establishment of specialised care units, equipped with cutting-edge medical technology and staffed with highly trained healthcare professions. The program will be implemented in a phased manner to ensure the successful completion of refurbishment and expansion of high-priority targets, and onwards to other facilities, based on their respective needs and capacity. The program will involve extensive stakeholder engagement with hospital staff, patient representatives, local communities, researchers, and healthcare experts. We will ensure the transparency of the initiatives through regular updates and progress reports related to the public and stakeholders.
• The Specialised Centres of Excellence Development (SCED) Program will advance medical research, treatment, and patient care by concentrating resources and expertise on specific medical conditions and treatments in specialised facilities. We will conduct a thorough assessment in collaboration with medical experts, community organisations, patient representatives, and researchers to identify priority medical areas based on healthcare trends, prevalence of diseases, and unmet medical needs. The program will allocate specific funding for target hospitals and medical centres to build new infrastructure required for specialised care, research and treatment, equipped with specialised research equipment and cutting-edge technology, and staffed with high-trained specialists. We will create training programs and resources to build expertise in the specialist medical fields. SCEs will be encouraged to create multidisciplinary teams comprising physicians, surgeons, researchers, nurses, support staff, and data analysts to collaborate on addressing complex medical challenges comprehensively. The program will promote research initiatives, clinical trials, and translational studies to be conducted in SCEs, in collaboration with academic institutions, industry partners, and research organisations. The centres will prioritise patient-centred care, providing personalised treatment plans and holistic support for patients and their families; establishing patient advisory groups to meet patient needs and expectations effectively; and actively engaging with patient communities, offering educational programs and support services related to specific medical conditions. The program will actively participate in international medical collaborations by sharing their expertise and best practices, facilitating partnerships with global healthcare leaders to promote joint research projects, and inviting foreign medical professionals and researchers to collaborate in SCEs in Nouvelle Alexandrie.
• The Regional Healthcare Facility Fund (RHFF) will support infrastructure enhancements in all regions of Nouvelle Alexandrie, focusing on community-based healthcare. We will conduct a comprehensive needs assessment to identify healthcare infrastructure gaps and challenges in different regions, considering factors such as population size, demographic characteristics, existing healthcare facilities, disease prevalences, and social determinants of health. The fund will be distributed on a grant basis, with a structured application process for Hospital trusts and healthcare authorities, subject to a review committee consisting of healthcare professionals, industry experts, and local authorities, with evaluation based on merit, feasibility, and alignment with program goals. The fund will allocate specific funding  for the construction, renovation, equipment upgrades, and technology implementation of GP clinics and community health centres. An emphasis will be placed on innovation and efficiency, investing in digital health solutions, telemedicine, and mobile health clinics. Specific funding will be allocated to support transport links and accessibility of healthcare facilities.
• The Mobile Healthcare Unit (MHU) Program will establish and deploy new mobile healthcare units. We will conduct a comprehensive assessment to identify underserved and remote areas lacking adequate access to healthcare services, in collaboration with local authorities, community organisations, and researchers to ensure an accurate and updated list of target locations. The program will procure and fully equip mobile healthcare units with high-quality medical equipment, diagnostic tools, and necessary supplies to provide essential medical services. They will be designed to be versatile, capable of reaching various terrains locations, focusing especially on rural villages and remote communities. We will recruit qualified healthcare professionals, including doctors, nurses, and medical assistants, to staff these MHUs. The units will perform essential services, including basic consultations, preventive care, and minor procedures. They will also conduct regular health screenings, including blood pressure checks, diabetes screenings, and ENT checks; as well as perform vaccinations, to promote early detection and disease prevention. Each unit will be equipped with telemedicine technology, connected with regional or tertiary hospitals, to allow real-time consultations and collaboration with specialists. We will prioritise community engagement and health education by MHU, to remove pressure on healthcare facilities, in conjunction with local healthcare providers and community leaders. We will establish key indicators, such as the number of beneficiaries served, health outcomes, and patient satisfaction, to evaluate and monitor the effectiveness and impact of MHUs. We will collaborate with private partners and NGOs to ensure scalability.

Digital Transition

We believe that the adoption of digital health solutions will significantly improve the quality of healthcare, reduce waiting times, and improve patient outcomes and experiences.

• The National Interoperability Framework (NIF) will set the standards and guidelines for uniform data standards across our healthcare. It will be overseen by a task force composed of healthcare professionals, health IT vendors, patient representatives, and regulatory authorities. The framework will standardise technical standards & specifications, data formats & semantics, and protocols to ensure compatibility between different health IT systems used by healthcare providers. These data standards will include clinical data, patient demographics, medication records, laboratory results, and other relevant health information. It will establish a national certification for health IT systems, which will be required for vendors going forward. Regular audits will be conducted to ensure compliance. We will create dedicated testing centres equipped to rigorously simulate health IT systems for interoperability before deployment, as well as conducting thorough validation to verify compatibility and adherence to the framework.
• The Health Information Exchange Hub (HIEH) will facilitate seamless data exchange between healthcare providers. It will be created in collaboration with experts in health informatics, software developers, clinicians, and researchers. There will be a specific focus on user-friendliness, scalability, and interoperability with existing health IT systems. The platform will prioritise patient data security and privacy, by implementing state-of-the-art encryption protocols and security measures to safeguard patient health information during transmission and storage; including through access controls, two-factor authentication, and audit logs. The platform will support common data formats and protocols, through dedicated high-performance data centres. Such centres will adhere to standards for redundancy, disaster recovery, and data backup. A dedicated team of developers will maintain and continuously improve the platform, through dedicated allocation of resources for ongoing maintenance, bug fixes, updates, and user support services. Regular evaluations and feedback mechanisms for users will identify areas for improvement and optimise the platform’s functionality.

Primary Care Development

We will place a specific focus on our primary care, to lower hospital uptake and improve patient outcomes through enhanced GP services.

• The GP Training Places Program (GP TPP) will provide medical students with financial support when pursuing careers in general practice. These will consist of scholarships that will cover tuition fees, course materials, and transport expenses. They will receive this support throughout their medical school, foundation years, and GP specialty training. We will also provide support for relocation and student loan repayment assistance. The program includes financial incentives, including competitive salaries, signup bonuses, and subsidised continuing education opportunities. Furthermore, the program will provide support for active GPs facing challenges in their practice, such as workload management and mental health support. GP TPP will conduct thorough needs assessments to identify areas of low GP density, and incentivise students to relocate to target areas, through a relocation allowance, as well as providing technology to conduct telemedicine and remote consultations.
• The GP Retention and Returners Program (GP RRP) is a scheme to encourage retired GPs and those on career breaks to return to practice. For this, we will offer flexible working arrangements and establish mentorships to support reintegration into active practice, with a focus on updating clinical skills and knowledge to meet current medical standards and guidelines; as well as establishing peer support networks to encourage returners to connect and share experiences. There will be financial incentives in place, including through a return-to-work stipend, reintegration allowance, and relocation support. The program will launch an outreach campaign to inform eligible people, with targeted communications through medical associations, online platforms, and ads in medical journals.
• The Care Coordination and Plans (CCP) Initiative will create collaboration between primary carers and community health services. The plan will create a framework which will standardise care coordination protocols that outline the processes and responsibilities for transferring patient information between primary care settings and community-based services, addressing the sharing of relevant medical information, medication reconciliation, and coordination of follow-up care after hospital discharges or specialist consultations. The framework will also mandate primary care providers to develop and maintain comprehensive care plans for patients with complex health needs. These care plans will be tailored to address the specific health and social needs of each patient, taking into account medical conditions, social circumstances, and individual preferences. The plans will be collaboratively developed with the patient, family or caregivers, and relevant healthcare professionals, and will include clear treatment goals, a timeline for interventions, and mechanisms for regular review and updates of health status changes. We will establish training programs to equip primary care teams with necessary skills and knowledge for various aspects of care coordination, including communication strategies, teamwork, patient engagement, and utilisation of health IT tools. The program will establish care coordinators or care management teams responsible for patients with complex health needs, acting as the central point of contact. They will receive specialised training and support in care management.
• The Comprehensive Community Services Program (CCSP) will offer a broad range of services that address various aspects of health and wellbeing. We will allocate specific funding to implement evidence-based preventive care programs, providing resources for regular check-ups, medication adherence support, and patient education on self-management. The program will support efforts to integrate mental health and behavioural health centres within community health centres, and foster collaboration between primary carers and behavioural health specialists. We will implement screening and early intervention programs to identify individuals with mental health concerns and facilitate timely access to appropriate services. We will support access to dental care in community health services, upgrading existing ones with modern technology and equipment; as well as launching oral health promotion programs to raise awareness on oral hygiene and regular dental check-ups. The program will establish social support programs in community health centres to address social determinants of health, providing assistance with housing, transportation, food security, and employment, in collaboration with community organisations and social service agencies. We will allocate target funding for programs focused on at-risk populations, including maternal and child health and geriatric care. These focus both on preventive care, chronic disease management, and mobility support. They also include substance abuse treatment programs that provide counselling, rehabilitation, and support services.
• The Community Health Worker (CHW) Program will serve as a link between healthcare providers and community members. A framework will be established to define clear roles and responsibilities for community health workers, including their scope of practice. The program will focus on underserved and disadvantaged areas. It will work to develop mechanisms to integrate CHWs into primary care settings, hospitals, and community health centres, involving them in social determinants of health, such as housing, nutrition, and transportation. They will be trained specifically to provide culturally competent support, focusing on diversity, cultural competence, and sensitivity; enabling them to navigate cultural barriers in healthcare delivery. CHWs will be empowered to conduct community-based health education sessions, with a focus on preventive care, disease management, and healthy lifestyle practices, utilising mobile health units and community outreach. They will also offer specific navigation services to assist in scheduling appointments, accessing health insurance, and understanding medical information. They will provide follow-up care and monitoring for patients with chronic conditions to ensure treatment adherence and continuity of care, in collaboration with healthcare professionals. The program will establish collaborative networks between CHWs in conjunction with community organisations, as well as offering continuous professional development opportunities and clear career pathways, focusing on long-term commitment and retention.

Integration of Health and Social Care

The Government envisions a seamless integration of health and social care services to improve overall care coordination and outcomes. We aim to develop collaborative care models that bridge the gap between healthcare and social support systems. We will promote community-based care, create partnerships, and enable seamless transitions between care settings. This will address the social determinants of health, support individuals in their homes, and provide holistic approaches of those with complex needs.

Collaborative Care

We will work towards fostering closer integration between health and social care services to improve care coordination and outcomes, pooling their resources to enable integrated care planning and provide holistic care for individuals with complex needs.

• The Integrated Care Pathways for Complex Needs (ICPCN) Program will provide comprehensive and coordinated care, enabling local health and social care providers to collaborate. The program will establish Joint Steering Committees to oversee the development and implementation of ICPs for various complex needs, including multimorbidity, mental disorders, and disabilities. These JSCs will consist of healthcare professionals, social workers, patient representatives, policymakers, and researchers. They will conduct regular evaluations to review progress, address challenges, and make data-driven decisions to enhance the effectiveness of ICPs. The program will establish training programs and capacity building projects to build on skills in collaborative care, such as care coordination, information sharing, joint decision-making, and person-centred care. The ICPs will include comprehensive assessments to identify unique healthcare, social and emotional requirements for individuals with complex needs, including also on social determinants of health, mental health, family support, and community resources available to the individual. Feedback mechanisms for patients and caregivers will identify improvements and address challenges.  
• The Transitions to Home Program (THP) will address the challenges that patients often face during the transition from hospital to home. It will establish hospital liaison teams comprising social workers, nurses, and discharge planners. These teams will conduct thorough assessments of discharge needs, taking into account medical, social, and psychological circumstances; coordinate with hospital staff and primary care providers to develop personalised discharge plans; and provide patients and their families with detailed information about post-discharge care plans, medication management, and potential warning signs. The teams will also conduct regular home visits to monitor health status, wound care, medication adherence, and provide necessary medical interventions. The program will also fund community-based rehabilitation programs to support patients in recovery, including through physical therapy, occupational therapy, or psychological counselling. We will collaborate with community organisations, support groups, and charities to provide additional resources and assistance to patients and their families, including through integration into community programs such as social events, peer support programs, and recreational activities. Through regular evaluation and monitoring, utilising key performance indicators such as readmission rates, patient satisfaction, and successful care transitions, we can adapt and improve the program.

Community-Based Care

We will promote community-based care services to support individuals in their own homes and reduce hospital admissions.

• The Community Care Support Initiative (CCSI) will provide comprehensive care and support to individuals in their own homes. The program will provide financial support to individuals using social care services, including home nursing, palliative care, and rehabilitation services. These funds will cover at least part of the expenses incurred by the use of these services. The program will ensure that a range of medical and non-medical services are eligible for the financial support, including wound care, medication management, pain management, personal care assistance, physical therapy, and occupational therapy. The program will foster collaboration between primary care providers and social workers to develop personalised care plans for home-based care, addressing the specific needs and goals of each patient. The program will implement a system within healthcare settings to identify patients at risk of hospitalisation due to health conditions or circumstances. The system will involve screening tools, risk assessment algorithms, and information sharing between primary carers, hospitals, and social workers; this information includes health status, test results, and care plans. These assessments will be used to develop targeted interventions to prevent hospitalisation, including enhanced home-based care, rapid response teams, telehealth consultations, and increased access to specialist services.
• The Informal Caregiver Respite Program (ICRP) will provide ICs with much-needed respite and training. The program will establish and provide funding for specific Respite Care Vouchers, giving ICs temporary caregiver support from professional care providers, specialised respite care facilities, or registered caregivers within their community. The vouchers will be flexible to allow ICs with the choice best suiting their needs and preferences. We will establish training workshops for ICs in collaboration with healthcare professionals, educators, and caregiver support organisations, covering various topics such as medication management, mobility assistance, emotional support, and cultural sensitivity. We will ensure these workshops are given in multiple languages to cater to the diverse IC population. The program will establish peer support groups for ICs, facilitated by social workers, psychologists, and healthcare volunteers. These groups will offer regular meetings both in-person and virtually, sharing experiences, providing ongoing emotional support, and exchanging caregiving tips. Specialised groups will be designed to address the needs of caregivers of patients with complex needs, including Alzheimer’s and children with special needs.  
• The Social Prescribing Program (SPP) will enable healthcare professionals to refer patients to non-medical services, improving overall well-being and health outcomes. The program will establish a collaborative network of primary care providers, community-based organisations, charities, and local authorities to create a wide range of social prescribing options, including fitness classes, mental health support groups, arts and crafts workshops, gardening clubs, financial advice, and community volunteering. The network will be supported by a dedicated online platform that is user-friendly and regularly updating, including contact details, descriptions of services, eligibility criteria, and any associated costs. A framework will be established to create a streamlined and efficient referral process to allow healthcare professionals to easily refer patients to appropriate social prescribing options, with timely feedback and updates on patients’ progress on social prescribing activities. We will launch a public awareness campaign to inform patients and healthcare professionals about the benefits of social prescribing, and encourage active participation.

Child Health and Social Care

We want to ensure that our children have the best start in life, by ensuring that child health is maintained, and our schools work closely with health and social care providers.

• The Integrated Child Health Teams (ICHT) is a program that will create health teams consisting of paediatricians, nurses, social workers, and educational specialists. This team will work to create a coordinated care plan for children, working closely with families, schools, and other relevant stakeholders, taking into account medical conditions, social circumstances, mental health, and educational requirements. The plan shall focus on family-centred care, actively engaging families and providing guidance to parents and caregivers. The team will coordinate appointments, referrals, and services to ensure seamless care transitions for children. Specific funding will be allocated on mental health support, providing counselling and resources to children and their families. We will establish training programs to help ICHTs to enhance their skills in child development, effective communication, cultural sensitivity, and collaborative decision-making. We will conduct regular evaluations and implement a feedback mechanism for parents and caregivers to identify areas of improvement and adapt the program for the specific needs of children and their families.
• The Early Childhood Development Program (ECDP) will provide comprehensive and accessible support for families with young children. This will establish new ECD Hubs in community health centres, which will be easily accessible, specifically for underserved communities. The hubs will offer child-friendly environments, with play areas and age-appropriate educational resources. The hub will be staffed by an integrated team of primary care providers, paediatricians, early education providers, social workers, and child psychologists. The teams will conduct assessments and develop individualised early development care plans for children and their family. The Hubs will offer multiple services, including parenting classes, developmental screenings, family counselling and support, and health and nutrition services. They also include vaccinations. The team will also empower parents and caregivers by providing educational materials and resources to support their understanding of child development milestones and the importance of play in learning.
• The Multi-Agency Child Protection Teams (MACPT) will create a shared platform for sharing information on child welfare. These teams will consist of healthcare providers, social carers, educators, law enforcement, and charities. The teams will prioritise early identification of children at risk and those experiencing significant health or social challenges, and create early interventions and care plans, considering social status, health conditions, mental health, and their families. The teams will develop and implement coordinated safeguarding plans that outline actions to ensure children’s safety and well-being, specifying roles, responsibilities, and timelines for agencies involved. The teams will be supported by a dedicated online platform to enable secure and fast information sharing, with a strong focus on data protection and confidentiality. We will implement regular evaluation of safeguarding plans and intervention outcomes to identify areas of improvement and adapt the program for the specific needs of child protection, including the continuing development of the internet.

Dentistry

The Government believes that a proper standard of dental care is vital for children’s development, but also for public health. We will work to expand dental coverage to ensure universal coverage for individuals with high needs. We will promote oral health and overall well-being by ensuring timely and affordable access.

Affordable Dental Treatments

We will reform dental treatment charges to make dental access more affordable. This includes a thorough assessment with dental professionals to establish a transparent and reasonable pricing structure for dental treatments. We will also place an inflation-linked cap on charge increases.

• The Dental Access Program (DAP) will provide subsidies for low-income individuals and vulnerable populations. These subsidies will come in the form of vouchers that ensure that eligible individuals have expenses covered for at least three dental check-ups each year. It will also offer affordable care packages for routine preventive services.

Oral Health

We will work towards creating a comprehensive public health program that promotes the significance of oral hygiene, regular dental check-ups, and preventive care.

• The National Oral Care Initiative (NOCI) will provide a comprehensive campaign on oral health. The initiative will fund two sets of programs: it will fund the School-based Oral Health Program (SOHP), which will conduct workshops, seminars, and interactive sessions to teach both students and parents about proper oral hygiene. The Federak Dentistry Office will furthermore work to integrate oral health education into school curricula, through the development of educational materials, and free oral care kids. Lastly, NOCI will have a dedicated online platform that is user-friendly, and includes interactive materials to offer guidance on oral hygiene practices, nutrition, and the importance of regular dental check-up. It will also provide a secure tool for virtual consultations and Q&A sessions with dental professionals.
• The Community Oral Health Awareness Program (COHAP) will collaborate with local authorities and community organisations to host oral health workshops, seminars, and awareness campaigns. It will also provide free dental screening and information sessions to vulnerable individuals in local communities. Dentists will develop informational materials and resources to support COHAP.

Workforce and Infrastructure

We will work to expand the number of dental professionals nationally, to ensure universal access to dental care. We will also create new dental clinics in underserved communities, to address the geographical and socioeconomic barriers to oral care.

• We will create the Dental Workforce Expansion Program (DWEP), to alleviate shortage of dental professionals and bolster the workforce, which will enhance access, reduce waiting times, and improve overall oral health outcomes. We will collaborate with dental schools to provide scholarships and debt forgiveness programs to encourage dental students to pursue careers within dentistry. We will also fund postgraduate training programs to upskill newly qualified dental professionals to meet the modern standards. We will furthermore establish training programs and professional development opportunities for dental professionals. The programme will also launch targeted recruitment campaigns for areas with acute shortages.
• We will establish the Dental Clinics Expansion Program (DCEP) to create new dental access points to tackle regional inequalities in oral care. The programme will hold a thorough assessment to identify areas for site selection and infrastructure development. We will have a dedicated fund to establish new dental clinics, as well as dedicated funding to expand existing ones, with a focus on technology, accessibility, and capacity. We will also integrate dental units with the MHUs established in Chapter 3 to reach remote areas, which can provide basic dental check-ups and preventive treatments.

Midwifery

The Government understands that effective and compassionate midwifery care is essential for ensuring the health and well-being of pregnant individuals and their newborns. We will work to enhance midwifery services throughout the country, and provide a holistic approach to pregnancy and childbirth.

Workforce and Technology

We want to recruit and train additional midwives over the next five years, with significant funding dedicated to recruitment and training. We also want to develop advanced technology solutions to integrate midwifing with other vital healthcare specialisations.

• The National Midwifery Initiative (NMI) will address the increasing demand for maternity care services and enhance the quality of care for pregnant individuals and their newborns. We will launch a targeted recruitment campaign to attract midwifery students to join public hospitals, by providing scholarships and financial incentives, including apprenticeships and loan forgiveness programs. We shall also establish training programs and professional development opportunities. We will create a mentorship program to pair experienced midwives with newly graduated ones.
• We will also integrate midwifery services with mobile health teams to reach remote areas. These services will be able to provide pregnancy screenings, childbirth care, as well as postpartum services.
• We will ensure that midwifery professionals will be interoperable with EHRs, with specific modules for prenatal, intrapartum, and postpartum care. Midwife EHRs will also be accessible via secure mobile devices, to facilitate real-time communication and coordination, to aid in fast-paced maternity care scenarios.

Continuity of Care

We will implement Continuity of Care Models (CoCs) for pregnant individuals, ensuring they receive care from a single midwife throughout pregnancy, childbirth, and postpartum period. These models will create a midwife team to oversee personalised support, patient-provider relationships, and consistent communication throughout the care period. The model would be based on a patient-centred approach, which ensures active participation in decision-making and tailoring care plans for the unique needs and preferences of expectant parents. These programs will collect comprehensive data on maternal and neonatal outcomes, patient satisfaction, and healthcare utilisation. This data will be analysed, and utilised to continuously improve continuity of care models.