Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank the Chairman and the other members. I very much welcome this opportunity to meet them to discuss the Revised Estimates for 2022 — Vote 38, Department of Health. I am delighted to be joined by my colleague, the Minister of State with responsibility for mental health and older people, Deputy Butler.

Budget 2021 saw an unprecedented allocation of over €4 billion in additional funding for health. This funded Covid-19 responses, maintaining the existing level of service, but, critically, €1.16 billion of this funded vital capacity and reform measures. This included unprecedented numbers of additional beds, workforce expansion, home care hours and investments in national strategies. We are all aware that 2021 was a difficult year, with significant impacts from Covid and the need to deliver the vaccination programme. This meant that not all of these new measures could be delivered in 2021.

We estimate that approximately €650 million of the €1.16 billion was spent in 2021. However, I am very pleased that, as we enter a new phase in the Covid-19 pandemic and plan to scale back our emergency Covid-19 expenditure, the Government has made the full amount of funding available again this year, together with €319 million in additional funding for new measures. This means there is a further expansion of over €500 million from 2021 new measures still to be delivered in 2022. This brings the total available for additional capacity and reform for this year to over €800 million. This will fund an expansion of our workforce of up to 10,000 staff, over 300 additional acute beds and 3 million additional home care hours. It will also fund the full roll-out of the enhanced community care teams to move delivery of care out of hospital settings into the community.

I have mentioned previously my three priorities, which are also those of the Government, in delivering universal healthcare. These are improving access for patients, improving outcomes for patients and improving affordability for patients. This Revised Estimate continues the work done in delivering on all three.

On patient access, the aim is to address waiting lists by allocating an additional €200 million to the HSE and an additional €50 to the National Treatment Purchase Fund, NTPF, creating an access-to-care fund for this year of €350 million. I am providing funding for additional critical care capacity, with funding to open 19 additional critical care beds. This is on top of the substantial funding of €426 million provided in 2021 for overall bed capacity.

With regard to better outcomes for patients, the level of funding provided will enable the advancement of a number of priorities in 2022, including prioritising funding for women's health.

The level of funding provided will enable the advancement of a number of priorities this year, including prioritising funding for women’s health.

I have allocated an unprecedented €47 million towards investments in women’s health this year. This will allow us to introduce a number of very important measures, including free contraception, initially for women aged 17 to 25 years; and increased investment in a new approach to menopause care. Some €10 million has been provided to the women’s health fund for new targeted projects, such as initiatives to address period poverty. National strategies will be implemented that impact on women’s health with additional funding for maternity, obstetrics, gynaecology services and perinatal genetics, as well as funding in cancer, drugs and mental health.

I was delighted to announce only last week a new plan to reduce waiting times for children and adolescents waiting for orthopaedic care. This includes, of course, children waiting for intervention and help on scoliosis and spina bifida. Funding for the continued implementation of other national strategies is also included this year, including for the cancer strategy, the National Ambulance Service strategic plan and the trauma strategy and for the paediatric model of care, for organ donation and transplant services and for the social care strategies, including in the area of dementia and palliative care. It also funds the introduction of new regulations and legislation to expand the remit of HIQA, the roll-out of InterRAI assessments in nursing homes and more.

In terms of affordability for patients, budget 2022 responds strongly to the programme for Government commitment to introduce more care in the community and to make accessing services more affordable. This will reduce our dependence on the hospital-centric model of care.

In addition to the strategies mentioned above, I will provide for the extension of free GP care for children aged six and seven. This will benefit approximately 80,000 additional children this year. We will reduce the drug payment scheme threshold from €114 to €80, which will benefit approximately 70,000 people.

Actions will also be taken on a phased basis to reduce the financial burden of hospital charges for children. We have provided €30 million for new drugs and a further €36.5 million for a range of measures, including the safe-staffing framework, anti-microbial resistance and infection control and the implementation of the nursing home expert panel recommendations.

There is €37 million in additional funding for mental health services and €10 million designated from the Covid funding for mental health, providing a total of €47 million. There is €30 million to build on investment in older persons and dementia services; an additional €105 million for disability services, with a further €10 million in one-off Covid funding for disability services; an additional €10 million for Healthy Ireland; and an additional €6 million for social inclusion, including the national drugs strategy.

With regard to the financial position and the 2021 outturn, the gross provision for the health Vote in 2021 was €22.1 billion. That comprised €21.1 billion of current expenditure and just over €1 billion capital expenditure. The €21.1 billion represents the gross funding position for both the

Department of Health and the HSE and includes additional funding of €1.8 billion made available for current expenditure in 2021 in response to Covid-19.

The initial 2021 capital allocation was €893 million. In response to Covid-19, an additional €155 million was assigned, to bring the total capital allocation that year to more than €1 billion. The total cost of Covid-19 supports provided by Government to the health service in 2021 was €1.9 billion. These measures continue to be relevant in 2022 as the pandemic continues.

In framing the 2022 budget, the Oireachtas allocated further additional Exchequer funding for the health sector. Gross health funding is €22.2 billion, comprising €21.1 billion in current expenditure and €1.1 billion in capital expenditure. This represents an increase of €51.6 million on the 2021 current expenditure budget, an increase of €1.1 billion or 5.9%, excluding Covid 19 expenditure. It recognises the Government’s commitment to providing a health service that improves the health and well-being of people in Ireland. Some €319 million of this is allocated to new measures. When taken with more €500 million from 2021 and new measures still to be delivered in 2022, it brings the total available for additional capacity and reform to more than €800 million for this year.

The 2022 capital allocation is €12 million above the 2021 figure, which represents a significant increase on pre-Covid-19 allocations and will contribute to the delivery of modern health facilities and equipment throughout the country, both aspects of Sláintecare and Project Ireland 2040 and the mission of universal healthcare.

The year 2021 was another difficult year for those working in healthcare. Our doctors, nurses, health social care professionals and everyone across the health service have been working tirelessly throughout this pandemic. The great success of our vaccine roll-out has allowed us to move back

to a more normal way of living and working. While Covid-19 has highlighted major challenges in our health service, it has also highlighted our strengths, including the resilience, professionalism, courage and innovative spirit of our healthcare workers.

Budget 2022 funds our ongoing Covid-19 response but, more than that, it is also about building capacity, hiring staff and bringing positive permanent change to our health service. The continuing investments made in recent years will mean that, through the reforms being enacted, Ireland will have a better and more resilient public healthcare service.

I will finish off topic. I extend my thoughts and sympathies to the people of Ukraine, as they face an outrageous and illegal invasion by Russia. I am pleased to see that Ireland is making its position known very strongly, including in its role in the United Nations, at this time.