Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

Budget 2024 provides an additional €2 billion for healthcare, including €808 million in core funding, €1.032 billion in non-core funding and €156 million in capital funding. The total health budget for 2024 is €22.5 billion. The €808 million increase in core funding comprises a combination of €708 million to maintain existing services and €100 million for new developments. Funding to maintain existing services includes funding for inflation, rising patient demand, workforce measures including the public-only consultant contract, building momentum and pensions, as well as increases forecast for the State Claims Agency.

The €100 million in new development funding is to build on investments already in train. This includes staffing for 162 new hospital beds, 22 new critical care beds, our first six surgical hubs in Tallaght and new community beds. It is funding for college training places and progress in advanced practice. It is funding for improving patient access via our waiting list and emergency care initiatives. Progressing the new patient services is being dealt with through various items including the waiting list action plan. In the context of eHealth, there is funding to progress better digital supports for workers. We are expanding free contraception to people who are 31 years of age. As a result, no woman will age out of the programme next year. What is happening with mental health, older persons services, public health and social inclusion will be covered by the Ministers of State, Deputies Butler and Naughton.

The €1.032 billion in non-core funding includes continuing Covid vaccines and testing and tracing, services to Ukrainians fleeing war and our waiting list and urgent and emergency care plans. It includes building up the HSE’s cybersecurity and digital capabilities and addressing non-pay funding pressures in hospitals this year. We will be fully implementing the safe staffing framework.

In the past three years, the Government has delivered record investment in healthcare. We have added 22,000 staff since 2020, including 6,700 extra nurses and midwives, 3,100 extra health and social care professionals and 2,500 extra doctors and dentists. We have added more than 1,000 new hospital beds. We have delivered a big increase in critical care beds. This investment is having a positive effect. Last year, waiting lists fell for the first time since 2015. In fact, there are around 140,000 fewer people waiting longer than the Sláintecare targets, the ten- and 12-week targets, than there were at the Covid peak.

We have abolished inpatient hospital charges. Free contraception has been rolled out. Half a million more people have access to free GP care. State-funded IVF has just been introduced. The drug-payment threshold has been reduced to €80. Hundreds of thousands of diagnostic scans that GPs refer their patients to are being paid for by the State.

New services are becoming available for the first time in areas such as women’s health, diabetes, stroke, genetics, dementia and obesity. We are expanding existing clinical services where there are strategies in place. This includes in cancer care, maternity, trauma care, home care, cardiology, ambulance services, mental health and more. At the same time, as in many other countries, we are seeing extraordinary increases in demand for services against a backdrop of high inflation. As a result, the majority of this year’s budgetary funding is focused on absorbing price inflation and meeting growing patient demand.

There is a misconception that Ireland spends more on healthcare than other comparable countries. We do not. Of the 15 western European countries, Ireland ranks 11th in spending per person on health, accounting for local prices. Germany, the Netherlands, Austria, Belgium, France, Sweden, Norway, Switzerland, Luxembourg and Denmark all spend more per capitaon healthcare than we do, adjusting for local prices.

While we invest, we must also ensure that this investment is being used to the best possible benefit for patients. Most of the spending this year above what is budgeted for is due to higher prices and higher patient demand than was forecast and provided for in the last budget. Turning patients away from hospitals is not an option. Nonetheless there are opportunities to increase productivity. To that end, I have been working with the chief executive of the HSE and my Department for some time on a structured approach to seizing these opportunities.

To that end, I have been working for some time with the chief executive officer of the HSE, as well as my Department, on a structured approach to seizing these opportunities. This includes accelerating the implementation of the integrated financial management system and identifying opportunities in major spending areas, such as agency, overtime and procurement. For quite some time, we have been rolling out a productivity platform that will give us, for the first time ever, a clear central view of the amount of patient care being delivered in every hospital by every clinical team. This is the first time we will be able to forensically examine and compare productivity levels across our health service and use that to engage with healthcare providers to recognise the people who are doing extremely well, learning from them and sharing their practices, and identify those who are doing less well, are less productive and seeing what supports are needed to bring productivity up. In the shorter term, we will also improve cost controls in respect of areas including recruitment. In the context, the HSE will shortly provide details of further hiring freezes being introduced in areas where annual recruitment targets have been met.

In spite of record investment and important progress, we have a long way to go in terms of providing patients with the care they need when they need it. Waiting lists are still far too long. Emergency departments in too many hospitals are still under far too much pressure. I acknowledge the enormous difficulties this is causing for patients. I want to state clearly that improving speed of access for patients is the number one priority for me, for my ministerial colleagues in the area of health, for the Government, for my Department and for the HSE.

I will conclude by acknowledging the extraordinary work being done by our healthcare professionals all over our country every day. We in the Houses of the Oireachtas and the media tend to focus on what is not working for patients. That is exactly what we should do. However, we spend very little time discussing and recognising the vital care being delivered every day, at a very high level, by our healthcare professionals. For example, our healthcare professionals have taken 150,000 more patients off the waiting lists this year than targeted. The target in this regard was already ambitious. Waiting lists in the Republic are now half what they are in Northern Ireland. In regard to the number of patients waiting more than a year for a hospital procedure, the waiting lists in the Republic is now ten times lower than it is in Northern Ireland. This is thanks to the extraordinary work and dedication and the efforts being made by healthcare workers throughout the country. I acknowledge that and thank them for everything they continue to do. We are very lucky to have a health service staffed by highly skilled, dedicated professionals who, as we all know, provide great care all over our country every day to our friends, families and ourselves in our time of need. I assure them that we will continue to invest and to support them in the interests of patients.

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