Seán Kenny (Dublin North East, Labour)

Thank you Cathaoirleach. This is a very difficult year for the health services. A Sinn Féin Deputy said in the House yesterday that the Labour backbenchers were staying silent on the health service plan. I am not a Trappist monk. The Government has to face up to the terms negotiated with the troika by the previous Administration. The challenge for the Government is to mitigate the impact on front line health care services. There are things in the plan which are to be welcomed, such as the development of proposals to protect the viability of community nursing units; increases in intermediate and community care capacity; a significant strengthening of primary care services; the enhancement of community mental health teams; progression of the clinical care programmes and a more tailored approach to disability services.

The plan requires an outline of the type and volume of services to be provided. It has to manage the health services in a manner which will mitigate as best it can the impact staff reductions will have on services. It is essential, therefore, that the focus should now switch to implementing the many reforms which are outlined in the plan and to managing the risks facing the health services.

In terms of staff numbers and pay savings, HSE target numbers were about 104,500 at the end of 2011, which is around 800 under the ceiling. The ceiling for the end of 2012 is about 102,100, which is a reduction of 3,200 compared to the 2011 target. I understand these figures are still being finalised.

The scale of the financial challenges facing the HSE, and the resulting staffing challenges, means there will be an inevitable and unavoidable reduction in services. The plan commits the HSE to minimising this impact by fast tracking new, innovative and more efficient ways of using the reducing resources. It reflects the need to move to models of care across all services and care groups which treat patients at the lowest level of complexity and provide services at the least possible unit cost. It also includes a commitment to addressing staffing levels, skill mix and staff attendance patterns and rosters within the context of the public service agreement.

Under the plan, hospitals will work closely with the special delivery unit to ensure that nobody waits longer than nine months for an elective procedure. Indeed, nine months can be a long time for somebody in pain. I certainly hope that their projections are accurate. I hope there will not be a repeat of the accident and emergency trolley crisis reported to me by constituents late last year, where old people lay on trolleys in Beaumont Hospital for long periods before being moved. I wish to pay tribute to the Beaumont Hospital staff and to accident and emergency staff in particular, who make heroic efforts to cope with the demands placed upon them.

In line with the commitment in the programme for Government to a significant strengthening of primary care services, additional funding of €20 million is being allocated to fill as many vacancies as possible. This will be increased to €25 million if it can be established that there is scope for further savings of €5 million in demand-led schemes. Funds have also been prioritised for the HPV vaccine programme and the catch-up measles vaccination campaign. GP visit cards will be issued to long-term illness claimants in line with the programme for Government. Based on the projected 2012 outturn, an increase of 105,000 medical cards is anticipated.

It is also intended to roll out a national chronic disease management programme for diabetes in 2012. Preparations will be made for the roll out of similar initiatives for other chronic diseases including stroke, asthma and heart failure. Outside of the fair deal scheme, home care packages which allow the most dependent older people to remain in their own homes will not be reduced in 2012. An additional estimated 1,270 clients will be supported under the fair deal scheme. The HSE will also work with the Department to increase intermediate care capacity by reallocating funding from long-term residential care and potential other sources such as acute hospitals.

An additional €35 million will be allocated to mental health services in 2012, targeted at improving child, adolescent and adult community mental health teams, as well as suicide prevention and counselling services. In addition, a number of inpatient child and adolescent units will open during 2012.

This country faces stark choices. It was the actions of the previous Administration that led us to this point. Despite all of that, this Government is investing as much as it can, where it can. There are adjustments in some areas, along with investments in other areas, in order to improve on services and increase provision of services. This Government is doing its very best to weather this very difficult storm.

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