Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I welcome the opportunity to address the House on budget 2020 and the 2020 health Estimates. In line with the overall strategy of the Minister for Finance and for Public Expenditure and Reform, the health budget has been completed on the assumption of a disorderly Brexit. The Irish economy will face challenges arising from this in 2020 but we can and will meet these challenges if we make sensible decisions now and focus on our strategic goals. That was at the heart of budget 2020.

For me, from a health perspective, this budget is about truly bringing Sláintecare to life in communities across the country. We made a lot of effort on a cross-party basis to put together the Sláintecare plan. It was a once-in-a-generation opportunity to reform the health service and take party politics out of the direction of healthcare and with budget 2020, this cross-party vision is becoming a reality. In recent weeks, we have taken a number of significant steps to see real, tangible progress with Sláintecare. We have made the decision to dismantle the HSE as it is constructed and to appoint six regional health areas in line with Sláintecare. We have awarded €20 million in Sláintecare integration funding for 122 projects in every county across the country. We published the report by Dr. Donal de Buitléir on private practice in public hospitals, showing that if we want to deliver real care in public hospitals in a better way, we have to address the thorny issue of private practice in public hospitals.

The budget announced yesterday builds on the foundations laid in the past year, particularly with the provision of multi-annual funding for the recruitment of 1,000 front-line community healthcare workers between now and 2021. This is the aspect of the budget I am most excited about when it comes to healthcare. We have built so many wonderful primary care centres across the country. We have 127 in operation. Everybody inside and outside of this House tells me that they need to be busier. The only way they can be busier and the only way more can happen within them is if we staff them. A ring-fenced fund, on a multi-annual basis, for 1,000 front-line staff will mean more speech and language therapists, more occupational therapists, more physiotherapists, more psychologists, more public health nurses and more of all those posts one would expect to see being created in the community. That includes ten extra dementia advisers, which I know there has been a real cross-party focus on in this House and beyond for quite some time. Bolstering capacity in the community and in primary care is vital if we are to restructure our health service around the community and the patient over the coming year and move away from the hospital-centric model of healthcare. The expansion of community staffing is exciting but it is not the only strategic support to the implementation of Sláintecare delivered by the budget.

We are providing an additional €32 million in ring-fenced funding for Sláintecare and placing a very strong focus on measures which increase care services in the community, which is absolutely vital if we are to reduce waiting lists. In 2020 we will support GPs in managing chronic conditions, preventing further hospital admissions. This will mean paying GPs more to look after patients with chronic conditions, patients who up until now have been going to the hospital for their appointments. We will support families in caring for their elderly and young. This is a key element of providing the right care in the right place at the right time and at the right price, given that we are limited, as all health budgets are.

I would like to provide the House with some more detail on all of these measures. General practice will play an essential role in delivering on our Sláintecare ambitions. The revised contractual arrangements with GPs will provide for a structured approach to the management of chronic disease which will benefit more than 430,000 medical card and GP visit card patients, bringing the investment to date under the revised GP visit contract to €80 million. Ensuring people can access healthcare and medicines without financial hardship is also a key pillar of Sláintecare. Some €45 million has been committed to this end. It involves the reduction of prescription charges for those under and over 70 years and the reduction in the monthly drug payment scheme threshold; therefore, it will be cheaper for people to buy medicine for their family if they go to the pharmacy, regardless of whether they are medical card holders. We are also expanding the income thresholds to qualify for the medical card for people over the age of 70 years in order to look after older people, also benefiting 50,000 more people over the age of 70 years with medical cards.

We are expanding the roll-out of free GP care services, but we are doing so on a phased basis. They will be extended to children under seven years at the start of the next school year. For the first time ever, there will be a free dental care package for children under the age of six years, in line with our new oral health policy, Smile agus Sláinte.

We are putting more money into the National Treatment Purchase Fund, NTPF, bringing the total budget to €100 million. It cannot be the National Treatment Purchase Fund of old. It cannot just be about giving money to private hospitals. It has to be about using public capacity. I see that the Chairman of the Joint Committee on Health, Deputy Michael Harty, is present. He has highlighted capacity in Ennis that he would like to see used. We have done more in Nenagh Hospital with the new cataract theatre, funded through the NTPF. We have opened more theatres in Bantry General Hospital using the NTPF. This Friday I will meet representatives of the NTPF to set them a challenge to come up with Sláintecare initiatives and community diagnostics solutions. This is not just about putting more money into private hospitals, far from it.

Of course, we are also providing more funding for home care services, with an additional 1 million home care hours. In 2020 we will see the first reduction in homecare waiting times in many years. I refer to the roll-out of the new statutory home support scheme, something the Minister of State, Deputy McEntee, started when she was in the Department of Health and on which the Minister of State, Deputy Jim Daly, is building. The budget includes €26 million for winter funding, more funding for mental health services and more funding for disability services. Yes, there is more funding for health servoces, but it is also about doing healthcare differently and bringing Sláintecare to life.

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