Mr. Paul Reid:

I thank the Chairman. Good morning members. I thank the committee for the invitation to meet with it to discuss the HSE National Service Plan 2022. The plan outlines the health and social care services that will be provided to the people of Ireland in 2022 within the allocated budget of €20.7 billion, which includes: additional investment in new measures, including the winter plan, of €310.3 million; and additional existing level-of-service funding of €727.4 million, including €286 million pay-cost pressures for funding increments of €39 million, €364.4 million for existing levels of service and demographics and €77 million in respect of 2022 full-year costs relating to table 4 of the National Service Plan 2021.

The plan also outlines additional once-off investment specified for Covid-19 costs of €697 million including: €497 million to cover Covid-19 responses, including but not limited to, vaccination, testing and tracing, personal protective equipment, and hospital and community Covid-19 responses; and €200 million to cover acute and community-scheduled care access, waiting lists and waiting times, including use of public and private hospitals. In addition to submitting a national service plan, we have also submitted to the Minister a capital plan of €1.045 billion allocated in 2022, which includes an ICT capital plan of €130 million. The national service plan focuses on the delivery, improvement and reform of healthcare services while continuing to manage a Covid-19 environment, and it is prepared within the strategic context of Sláintecare, the HSE Corporate Plan 2021-2024, the Minister’s annual statement of priorities, and the winter plan.

Healthcare reform is focused on the need to change models of care and increase capacity to reduce waiting times, especially for those with urgent and complex care needs. The focus of the 2022 waiting list action plan is for waiting times for hospital procedures to be reduced to a maximum of one year by the end of 2022, and the maximum time an outpatient will have to wait to be assessed by a hospital consultant to be 18 months by the end of the year. In 2022, we are operationalising additional bed capacity, including capital and staffing, as follows: the final 308 acute beds from the 2021 national service plan, which included the approval of 1,146 beds; opening a further 72 acute beds in 2022; completing an additional 36 critical care beds; and completing an additional 258 community beds.

Reducing our dependence on the current hospital-centric model of care and supporting capacity building in the community is key to realising the vision of Sláintecare. This will, over time, reduce visits to and admissions from emergency departments and should lower emergency department waiting times more generally.

Through the enhanced community care programme and related programmes during 2022, we are progressing several initiatives, including completing the roll-out of 96 community healthcare networks, CHNs, establishing 30 community specialist teams for chronic disease management and completing the roll-out of 30 community specialist teams for older persons. Through our reform programmes in 2022, we are supporting people to live full lives in the community, with access to a range of person-centred community services and supports across their life spans and care needs. This will enable increased access to care and supports at home and in the community, thus reducing the requirement for long-term residential care and acute services. We are working to ensure compliance with standards and to reduce the number of people living in institutional settings by providing more appropriate community-based accommodation. This includes 120,000 additional hours of personal assistant supports, while 30,000 additional hours of home support are being delivered in disability services and an additional 2 million home support hours are being provided for older people this year. This will expand and enhance supports for people to live self-directed lives in their own communities.

The profound impact of the Covid-19 pandemic on mental health and well-being is evident across every sector in Irish life. We are continuing to reform mental health services and to improve access, with the focus in 2022 including: continued development and implementation of the agreed clinical programmes and new models of care; reducing waiting times for adults, children and young people; and improving the availability of and accessibility to services through increased provision and improved community mental health services. The foundation of a modern health service is integrated patient-centred care facilitated by collaboration between service users and all those working to deliver health and social care services. Implementing real and sustained reform at scale is complex and must be progressed in tandem with meeting the challenges of delivering day-to-day services.

Despite the extraordinary pressures and challenges faced by healthcare staff during the pandemic, much progress has been made on adapting service models in line with Sláintecare and principles of integrated care. It is also fair to say that challenges faced by the health service and experienced by service users before Covid-19 were exacerbated significantly by the pandemic, particularly with respect to access to local community support services, for example, including day services for older people and scheduled care in our acute hospitals. We are, however, always focused on delivering reform and enhancing the patient experience. This includes: improving service access across primary, community and acute services; addressing waiting lists and waiting times; increasing the range and capacity of services delivered to patients in community settings; increasing bed capacity; addressing health inequalities; focusing on health promotion; and ultimately bringing us closer to the delivery of Sláintecare, as set out in the Programme for Government: Our Shared Future.