Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank the committee for inviting me today. I am joined by my three ministerial colleagues, namely, Deputy Butler, Minister of State with responsibility for mental health and older people; Deputy Rabbitte, Minister of State with responsibility for disability; and Deputy Feighan, Minister of State with responsibility for public health, well-being and the national drugs strategy.

I thought it would be useful to use my opening comments to address the impact that Covid-19 has on the delivery of healthcare and our plans to deal with this. The first wave of Covid-19 led to an unprecedented interruption to normal healthcare activity, both in community and acute settings. While many vital services were maintained or restructured to respond more appropriately to Covid-19 related risks, other services were suspended or delivered on a reduced basis. In the acute settings, many health services were suspended on the advice of NPHET. The provision of other health services, particularly in community settings, was also affected.

Many steps have been taken within the HSE, over the past number of months, to restore services. Over the summer of 2020, the HSE prioritised, among other things, communications to advise and encourage the public to seek necessary healthcare and to attend appointments. Many critical services continued through all stages of the pandemic, including cancer services. Urgent and time-sensitive treatments are being prioritised, based on clinical considerations. Innovative use of technology also benefited outpatient appointments in 2020 and between March and December 2020, more than 557,000 patients attended a virtual outpatient appointment.

Notwithstanding the significant resumption efforts, the overall effect of this was that less non-Covid healthcare was delivered last year than in previous years. Waiting lists for care in the country have been too long for many years and this has been exacerbated by Covid. Our waiting lists have increased over the past year. There are more than 622,000 people waiting for an outpatient appointment. There are 81,000 people waiting on our active inpatient or day-case lists - almost 22% more than this time last year.

To tackle these waiting lists we are providing an unprecedented level of investment. The total budget for 2021 represents an increase of around 20% on the 2020 allocation. While €1.67 billion of this is for Covid-related care and supports, including our vaccination programme, there is significant additional funding for new measures. This money will be used: to address the known capacity deficits by funding more beds and employing more staff; to replace, insofar as possible, the lost capacity and activity due to Covid-19 with the necessity to operate at reduced levels for clinical and public health reasons; to ensure people can stay at home for as long as possible and be treated as close to home as possible, in line with Sláintecare. For example, we are providing funding for several million additional hours of home support. The money will also be used to help alleviate waiting lists with an ambitious access to care fund.

The HSE National Service Plan 2021 sets out how the funding will be used. There is an access to care fund, which, together with funding allocated to the National Treatment Purchase Fund, NTPF, comes to €340 million.

As I mentioned previously, some services have yet again been reduced or suspended out of necessity to assist in preventing the spread of the virus during the third surge. Given this, it is the intention of the HSE to keep the planned levels of activity, performance and reform as set out in the national service plan under close review and the chair of the HSE board has committed to updating me formally in April 2021 in this regard.

I would like to conclude by acknowledging that we cannot predict with certainty the future trajectory of this disease. We must continue to ensure that our response is agile and flexible. Most importantly, we must ensure the public feel safe using our health and social care services, and that everything that can be done, is being done, to maximise the availability and quality of those services.