James Reilly (Dublin North, Fine Gael) | Oireachtas source

There has been significant focus over recent weeks on the very demanding and challenging financial and resource constraints within which the HSE has been required to prepare and adopt its 2014 service plan. It is important to recognise that this focus is not particular to the preparation and adoption of this year's HSE service plan as similar constraints have applied in each of the last number of years as a direct consequence of the emergency financial situation the Irish State has had to address. At such an early hour of the morning I do not want to upset the Deputy opposite, but we all know why we are in these financial troubles.

As in previous years, the delivery of the health and social care services provided for in this year's service plan will focus on the dual challenge of protecting patient outcomes while, at the same time, reducing costs. This requires increasing emphasis on models of care that treat patients at the lowest level of complexity, providing safe, quality services at the least possible cost. I commend the manner in which the HSE and its workforce have successfully focused on how best to minimise the impact of unavoidable constraints on front-line services by utilising innovative and more efficient and effective ways of using scarce resources.

This year, the HSE needs to achieve saving measures of €619 million in order to remain within the approved 2014 health expenditure ceiling. It is important to recognise that the bulk of these required savings measures, including €268 million in pay and related savings and €172 million in reductions in pharmaceutical prices and expenditures and general practitioner fees, will not impact on the general public. These savings, allied to additional cost containment measures of €129 million in areas such as public procurement, shared services, value for money and energy efficiency savings, will allow the HSE to maintain and, in many cases, improve and build on the range of services provided to the public, as they reduce the cost of delivering such services to those in need.

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I refer to the ongoing work of the special delivery unit, SDU, which was established in the Department of Health in 2011 in order to drive down waiting times for both scheduled and unscheduled care in Irish hospitals and to introduce a major upgrade in the performance capabilities of the Irish health system. In the case of unscheduled care, there has been an overall reduction of 14% in the number of patients waiting on trolleys during 2013. This is on top of the 23.6% reduction achieved in 2012 compared to 2011. In terms of scheduled care, at the end of December, 99.99% of adult inpatients and day cases were waiting less than eight months, 95% of child patients on the waiting list were waiting less than 20 weeks and 99% of routine gastrointestinal endoscopy patients were waiting less than 13 weeks. The number of patients waiting over 12 months for an outpatient appointment has reduced by 95% in 2013, from a high point of 103,433 in March of that year to 4,626 at end of December 2013. The SDU and health service staff across the health system are to be commended on these positive developments.

The significant increase in the number of consultants over the past five years is also of note. In the five years since December 2008, the number of consultants has increased by 295, from 2,260 to 2,555. The number of doctors on GMS contracts has also significantly risen. On 31 December 2013, there were 2,413 GPs contracted to provide services under the General Medical Services scheme. This compares with 2,098 on 31 December 2008, an increase of 315 GP contract holders over this period.

In the light of these developments, I have every confidence that, despite the unavoidable resource reductions already referred to, the HSE will maintain core services in 2014 while also supporting the growing demand for services arising from population growth, increased levels of chronic disease, increased demand for prescription drugs, higher numbers of medical card holders and new costly medical technologies and treatments.

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