James Reilly (Dublin North, Fine Gael)

The gross current budget for the Health Vote group for 2012 is €13,644 million. An additional €79 million is to be raised through a number of measures to increase the level of income from private patients treated in public hospitals and to improve the collection rate of these charges. This reflects the Government's savings target of €183 million for the health sector in 2012. In addition, the comprehensive review of expenditure identified a range of unavoidable cost pressures and priority programmes for Government commitments. When account is taken of these and the Government's savings target, the overall target for the health sector is estimated in the review at approximately €540 million. Other unavoidable costs were not identified in the review which will also have to be addressed in the context of determining budgets for hospitals and local health offices. These include addressing an underlying deficit which it is carrying into 2012, as well as increments, the EU directive on agency workers and the VAT increase.

It is clear that 2012 will be a very challenging year for the health services. The combination of the savings measures, the absence of extra funding for unavoidable extra costs and service needs plus the further reductions in numbers employed will inevitably impact on services across all care programmes. The extent and nature of the impact on specific services will be set out in the HSE's national service plan for 2012 which was adopted by the board of the HSE and submitted to me on 23 December. I am currently considering the plan with a view to making a decision on it by the end of this week.

My Department has worked in collaboration with the HSE to develop the plan in the context of the comprehensive review of expenditure, the programme for Government reform agenda and commitments for mental health and primary care. The plan as submitted indicates at a high level the impact the savings measures will have on the various care areas. It would not be appropriate for me to discuss the details of the plan in advance of my final decision. However, I can indicate that there will be a greater emphasis on maximising the level of services through innovation and more efficient use of the resources available. I have already alluded to some of these when replying to the previous question. The HSE acknowledges the need to accelerate the process of health care reform and through the use of initiatives, such as the national clinical care programmes, to move to models of care across all programmes delivering services to patients and clients at the lowest level of complexity and the least possible unit cost. I hope to minimise the impact on services but the reality is that we are in very challenging times and there will be a consequence for every programme. We will work in tandem with the HSE, the unions and our staff to find ways of changing how we do our business while minimising the impact on service provision.

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