Peter Fitzpatrick (Louth, Fine Gael) | Oireachtas source

This year remains an extremely challenging one for the health services. The scale of savings to be achieved remains considerable. However, the health service has already risen to the challenge of delivering significant savings while maintaining and improving the health services. Since the onset of the recession, there has been a 20% reduction in the health budget, amounting to over €3 billion, a reduction of 10% in staff numbers, amounting to 10,000 staff, and an increase of 8% in the population.

The Minister for Health expressed concerns about the number of savings targets set for the health services in the recent budget. He requested that a validation process involving the Secretaries General of the Departments of Health, the Taoiseach, and Public Expenditure and Reform examining these targets. Following this process, the savings in the medical card scheme has been reduced from €133 million to €23 million. The Government has agreed to provide an additional €47 million for the health budget for 2014. This additional allocation was made possible because of the recovery in the labour market. Projected levels of unemployment next year are lower than projected at the time of the budget. The remaining €63 million in savings is being provided for on an interim basis from pension provisions.

A core objective of the health service plan is to maintain front-line services and prioritise safe, quality treatment for patients in a timely manner. Safety monitoring is a key priority. A comprehensive set of quality and safety indicators will be developed and monitored. Key reforms to be progressed include the establishment of a new patient agency to promote good safety practices in the health service and to provide advocacy support to patients; the establishment of a health care commissioning agency; a national pricing office; phased implementation of a money-follows-the-patient approach in acute hospitals; the establishment of hospital groups; a focus on actions to promote health and well-being; and the transfer of responsibility for child and family services from the HSE to the new Child and Family Agency.

A total of €35 million has been provided for an additional 60,000 medical cards. Approximately 420,000 children aged five years and under will benefit from free GP care as part of the move to universal health insurance. More than 90% of those aged over 70 will remain covered by either a medical card or a GP visit card.

Disability services will receive additional funding of €14 million and 130 additional staff have been provided to address priority needs in disability services. A total of €7 million is being allocated to provide an estimated 1,200 additional places for school-leavers. A total of €3 million is allocated to provide emergency placement for people with disabilities whose family circumstances have changed and who require an immediate and unplanned service response. A total of €4 million will deliver the required increase in services for children with disabilities, including autism. There will be no cuts to the level of home support and personal assistant hours. The target for the number of home service hours provided to people with disabilities in 2014 is 2.4 million. The target for the number of personal assistant hours provided to adults with a physical or sensory disability in 2014 is 1.3 million. The level of respite care will also remain the same as the 2013 level.

The priority for services for older people is to provide comprehensive home care and community support in order to maintain older people in their own homes and communities for as long as possible. The HSE provides home help and home care packages to approximately 56,000 people at any one time within an overall budget of €315 million. A total of 10.3 million home help hours are to be provided in 2014 and 10,870 home care packages.

The nursing home support scheme will continue to support over 22,000 people in long-term residential care at a cost of €939 million. An additional €20 million has been ring-fenced for 250 to 280 posts in the mental health services in 2014 to enable the strengthening of community teams, increased suicide prevention resources and clinical programme development and implementation.

The service plan provides funding for key service priorities in 2014 which include funding of €3.22 million to undertake bilateral cochlear implants; funding of €1.48 million to deliver patient-centred improvements in maternity care; an extra allocation of €8.3 million for cancer services; and €2.92 million for organ donations and transplantation services. Funding of €30 million has been provided to address waiting lists by increasing access to accident and emergency departments, day care and outpatient services. Funding of €3.1 million has been provided to implement a sustainable approach to the recruitment of non-consultant hospital doctors and to progress compliance with the EU working time directive.

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