Simon Harris (Wicklow, Fine Gael) | Oireachtas source

Yes, I will speak for eight minutes. I agree with one point made by Deputy Byrne, namely, the one on the centre holding. There are many people on the extreme of Irish politics who would not have thought that we could have delivered a budget and who did not do anything to contribute to that process.

I am grateful for the opportunity to address the House on the budget and the 2017 health Estimates. This is my first year as Minister for Health to address the House on this important matter. I am particularly pleased to be in a position to talk about a budget that will place the health service on a more sustainable financial footing and allow the Health Service Executive to set realistic and achievable targets for service areas in the year ahead.

I believe the message of the people at the last election was very clear - they wanted to see the gains of a recovering economy invested in the services people depend on and I believe this budget demonstrates that the Government has listened to that message. This year, 2016, is the first in many years that the health Vote has come in on budget. This is a direct result of the Government providing an additional €500 million funding to the health Vote last July to improve the base funding of health and to break the cycle of Supplementary Estimates that had developed in recent years.

The improving economy has enabled the health service to achieve much-needed budget increases in each of the past two years. The fact that it has come in on budget means we can use the funding we have received in this year's budget for services and service development, rather than to fill some black hole or overrun. The additional funding provided during the course of 2016 gave me, as Minister for Health, the opportunity to address some immediate issues facing colleagues, such as investment in a winter initiative to manage overcrowding in emergency departments, in addition to meeting commitments in A Programme for a Partnership Government.

I am pleased to announce that once again the Government is asking the Oireachtas to allocate additional Exchequer funding for the health sector for 2017. The gross current budget for the health sector for 2017 is €14.152 billion. This is equivalent to an increase of €457 million on the 2016 allocation of €13.695 billion voted through the year. The provision for 2017 represents a 7.4% increase on the original voted budget for 2016, and a 3.5% increase on the final projected 2016 outturn. The health Vote for 2017 has increased by 9.4% over the 2015 outturn position, recognising the Government's commitment to providing a health service that seeks to improve the health and well being of the people.

The additional funding secured will continue to ease the pressure on the health service to provide the optimum level of safe services for patients within the budgetary limits. However, there are still real fiscal challenges facing the health service. Health care demands continue to rise due to our growing and ageing population, an increasing incidence of chronic conditions and advances in medical technologies and treatments. Accordingly, we must continue to focus on effective financial management, cost containment and cost avoidance.

I am pleased to confirm that there will be no increase to prescription charges, the monthly DPS threshold or income thresholds for eligibility for medical or GP visit cards. Funding for fair deal will be maintained at an appropriate level to meet demand and keep waiting times at a maximum of four weeks. I believe this shows the Government's continuing commitment to stabilising the direct cost of health services for citizens. I am grateful to my ministerial colleagues, Deputies Noonan and Donohoe, for their support and understanding in dealing with the challenges faced by the health sector.

The level of health services to be provided within the available funding will be set out in the HSE's 2017 national service plan, which is currently being prepared by the executive. However, I will outline some of the issues which will be more extensively covered in the service plan. My ministerial colleagues, Deputies McGrath, McEntee, Corcoran Kennedy and Byrne, will be setting out information related to their own areas of responsibility so I will not do so here.

Under this budget, an additional €15 million will be allocated to the national treatment purchase fund, NTPF, to deliver a waiting list initiative in 2017 specifically directed towards providing treatment for our longest-waiting patients, because this is vital. This brings the funding available to the NTPF to €20 million in 2017, rising to €50 million in 2018, a total of €70 million illustrating this Government's commitment to improving waiting times for patients. In August, the HSE developed a waiting list action plan focused on reducing the numbers of longest-waiting patients. Throughout 2017, my Department will continue to work with the HSE on reducing waiting times through driving efficiencies and process improvements, with a particular focus on adherence to chronological scheduling and validating waiting lists. The NTPF is up and running now but this is not an excuse for the rest of our system to do everything it can possibly do to improve waiting times.

I am delighted that the €40 million allocated as part of the additional €500 million voted in July has been provided on a recurring basis for the winter initiative. This is important because winter happens every year. This funding is crucial in enabling winter-preparedness measures across our health service and in reducing overcrowding pressures in our hospitals.

The coming winter the initiative will deliver an additional 950 home care packages, an additional 58 transitional care bed approvals weekly; an additional 55 acute beds and an additional 18 step-down beds, as well as expansion of community intervention teams across four areas of the country and minor injury services in the Dublin area. The winter pressures on hospitals cannot only be resolved by additional provision in acute hospitals. We must also drive down the number of delayed discharges. I accept that there is a need for a bed capacity review and, probably, much more investment in bed capacity, but there are beds in the health service that are being occupied by patients who do not wish to be in them and do not medically need to be in them. For this reason, the focus of the winter initiative and the budget is on home care packages, transitional care beds, step-down beds, community intervention teams and so on. We also need to put in place a new GP contract.

I welcome the additional funding for acute and emergency services, which represents an increase of over €90 million on the revised allocation in 2016. The increased allocations in 2017 for acute hospitals, the National Ambulance Service and the National Cancer Control Programme demonstrate my commitment and that of the Government to driving key policy and strategic initiatives to improve and expand acute care and emergency services for patients. This funding will enable continued progress to be made on initiatives such as the delivery of the new national children’s hospital, implementation of Ireland's first maternity strategy and the winter initiative and drive improvements and expansion in cancer care for patients, ambulance services, waiting lists and paediatric services. We are also making provision for 1,000 new nurses to join the health service. I was pleased to be able to announce today an improvement in the pay of nurses who graduated between 2011 and 2015 by way of the restoration of their increments from January next.

In 2017, in line with the commitment in A Programme for a Partnership Government, we will increase investment in ambulance services. The capacity report identifies significant deficits in ambulance services which we will need to address incrementally in the next few years. Additional funding provided in 2016 has allowed us to start that process and the provision of further additional funds for 2017 will facilitate the development of the intermediate care service. This service focuses on providing transport for low acuity patients, including inter-hospital patient transfers. Through investing in the intermediate care service, we aim to free up the emergency fleet for emergency calls, thus improving the service overall.

On primary care services, it is proposed to progress the delivery of medical cards for all children in receipt of the domiciliary care allowance, as well as the new GP contract that is badly needed. My colleagues will outline other measures.

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