Frances Fitzgerald (Dublin Mid West, Fine Gael) | Oireachtas source

The first point I would make in response to the Deputy is that next year will see the highest health budget that has ever been allocated and, thankfully, we have an economy that can deliver that increase. That should be acknowledged because without that increase, we would not be maintaining current services. With that increased budget we can maintain current services and deliver new services. The increases amount to more than €1 billion since last year. That is a significant increase.

In terms of what the HSE service plan looks to deliver, it is to maintain existing levels of service and some new service development while also providing for the increase in need that arises from a growing and ageing population. Clearly, we have to have targeted service improvements.

There is no doubt that we face a major challenge. Everybody across the House knows the challenging situation we are facing as a result of the increased population, higher numbers of elderly people and all the demands that arise from that. It is extremely dismissive of the Deputy to describe the service plan in the way he has done, given the level of detail contained in it, including the commitment to improve services and the increased budget. Of course the HSE has to manage that budget and ensure it is put to the most effective and efficient use.

I agree there are unmet needs. We must work continually to meet the current demands, but I want to point out to the Deputy some of the initiatives that will be delivered next year under the new service developments provided for in the service plan. They include disability services, including provision of places in day centres for school leavers with a disability, which have long been a source of concern; hospital service developments, including the new national children's hospital; the medical card for recipients of the domiciliary care allowance; improved access to and increased funding for older people to home care packages; improvements in the national ambulance service delivery; and better access to mental health services. All that is spelt out in the context, for example, of acute hospital day case numbers where the expected activity level in 2017, at well over 1 million, is 4.2% above the figure for last year.

As the Deputy is aware, additional funding has been provided to address waiting lists, and that will lead to improvements, including the reduction of the number of patients on trolleys. There will also be increased services in the community. For example, the activity level for home care packages, including the delayed discharge initiative, has shown huge improvements already this year, and the Deputy knows the waiting list for the fair deal scheme has been reduced to four weeks. This time last year we were very concerned because the waiting list was ten, 12 or 14 weeks. It is now down to four weeks, and the delayed discharge issue has been dealt with. It is on its way to improving.

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