Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I am conscious that many issues pertaining to today's Revised Estimates, including how various health-related matters are to be funded and addressed in 2017, were discussed when I had a lengthy engagement with the joint committee last week. The script I have circulated can be taken as read. I will make a few brief points at the outset.

I hope the 2017 Revised Estimates can be seen as a practical example of how the Government is endeavouring to put the health service on a more sustainable financial footing and to allow the HSE to set realistic and achievable targets for service areas in the year ahead. On many occasions over the years, when health Ministers have come to this committee to consider Health Estimates, they have been looking at very different vistas from the vista we are looking at now as we consider how the health service is being funded in 2017. When the new Government came into office in 2016, it was able to provide additional funding to the health service. As a result, last year marked the first time in many years that the health sector was able to come in on budget in 2016 without the need for a Supplementary Estimate. This tells us that when the health service is funded adequately and expenditure in the service is carefully and closely monitored, we can ensure the health service comes in on budget. Coming in on budget is not just about meeting an accounting target or ticking a box; it means that any additional resources the Oireachtas decides to allocate to the health service can be spent on services that benefit patients. This allows us to move towards delivering the kind of public health service we all want to deliver.

I am keenly aware that there is significant concern about the waiting times for hospital appointments and procedures that are being experienced by patients. We had a lengthy discussion about this at the joint committee last week. I said on that occasion that the HSE was about to submit waiting list plans, including a specific plan for scoliosis, to me. The Department of Health has now received those plans. It is considering them and engaging with the HSE on them. I intend to share the plans with members of this committee very shortly. The overriding aims - that by the end of October, no patient will have to wait longer than 15 months for a day case or inpatient procedure or an outpatient appointment; and that by the end of this year, no child will have to wait longer than four months for a scoliosis procedure - have not changed. Those targets have been set by the director general of the HSE. I am very grateful to him for taking this issue as seriously as it should be taken. We were all appalled to learn about the lengthy times people are having to wait. The achievement of the four-month target will bring this country into line with the NHS practice in relation to scoliosis and the NHS timelines.

As Deputies can see from the documentation that has been provided, these Revised Estimates provide for additional investment in acute and emergency services, representing an increase of €90 million on the revised allocation in 2016. The additional funding that is being provided to the National Treatment Purchase Fund will bring its budget to €20 million this year. This will increase to €55 million in 2018. A sum of €40 million is being provided on a recurring basis for the winter initiative. This is crucial because it means that as we move towards the end of this winter - one would not think it from the weather today - we will be able to plan at an earlier stage for next winter. It is my intention that this work will get under way in the Department and the HSE very shortly. Funding is also being provided for the extension of the medical card to all children in receipt of domiciliary care allowance. Deputies will have noted that a Bill facilitating this extension was published this morning. I know the co-operation of all parties will be available to ensure the Bill in question passes all Stages in both Houses by the end of the month. I think we should all be working towards that target. Deputies will be aware that reductions in prescription charges for all medical card holders over the age of 70 and their dependants came into effect yesterday. This measure, which will benefit 390,000 people in this country, is a first step in advancing the key commitment in the programme for Government to reduce the cost of medicines for all our citizens.

In the mental health area, progress is being made in developing services in line with the model set out in A Vision for Change. Additional funding has been made available for the disability services directorate, encompassing the full year cost of school leavers. This has been a very thorny issue for a number of years because adequate additional funding has not been provided to deal with the number of new school leavers coming on board every year. Those full-year costs are being met this year.

There were additional therapy support costs as well as costs incurred from complying with HIQA standards. There is a significant commitment to the fair deal nursing home support scheme and I hope there will be progress this year in trying to develop a policy platform to have a similar scheme in place in terms of a statutory home care scheme. Given the Houses of the Oireachtas provide such significant levels of funding to the HSE to deliver a health service that we all want to see and work towards, it is important that we have a performance and accountability framework in place that can monitor it. My statement, which I have circulated, outlines how the framework works. We have secured a significant increase in funding for the health services in recent years, but that does not mean that I, or anyone else, should underestimate the significant challenges involved in the delivery of a safe and efficient health service for the Irish people. Finally, while many of our discussions tend to be on current expenditure, on Monday I will be ten months in this job and I have seen, as I have travelled around our houses, a real deficit in capital spending. The Government has a capital review coming up this summer which will see €2.36 billion in additional capital allocated across Government. Additional capital spending in health will see additional benefits and efficiencies in the interests of our patients.