Joan Collins (Dublin South Central, People Before Profit Alliance)
Link to this: Individually | In context

Question 3: To ask the Minister for Health if he will confirm that cuts in the health budget in 2012 will severely impact on frontline services and will result in longer waiting times for surgical procedures, the shortage of non consultant hospital doctors will mean longer waiting times on trolleys and longer queues in emergency departments and that the planned closure of community nursing units will impact heavily on older persons and their families and makes no economic sense whatever in view of the fact that the cost of caring for a person in such units is approximately €1,300 a week as opposed to €1,000 a day in an acute hospital [1599/12]

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

The gross current budget for the Health Vote group for 2012 is €13,644 million. An additional €79 million is to be raised through a number of measures to increase the level of income from private patients treated in public hospitals and to improve the collection rate of these charges. This reflects the Government's savings target of €183 million for the health sector in 2012. In addition, the comprehensive review of expenditure identified a range of unavoidable cost pressures and priority programmes for Government commitments. When account is taken of these and the Government's savings target, the overall target for the health sector is estimated in the review at approximately €540 million. Other unavoidable costs were not identified in the review which will also have to be addressed in the context of determining budgets for hospitals and local health offices. These include addressing an underlying deficit which it is carrying into 2012, as well as increments, the EU directive on agency workers and the VAT increase.

It is clear that 2012 will be a very challenging year for the health services. The combination of the savings measures, the absence of extra funding for unavoidable extra costs and service needs plus the further reductions in numbers employed will inevitably impact on services across all care programmes. The extent and nature of the impact on specific services will be set out in the HSE's national service plan for 2012 which was adopted by the board of the HSE and submitted to me on 23 December. I am currently considering the plan with a view to making a decision on it by the end of this week.

My Department has worked in collaboration with the HSE to develop the plan in the context of the comprehensive review of expenditure, the programme for Government reform agenda and commitments for mental health and primary care. The plan as submitted indicates at a high level the impact the savings measures will have on the various care areas. It would not be appropriate for me to discuss the details of the plan in advance of my final decision. However, I can indicate that there will be a greater emphasis on maximising the level of services through innovation and more efficient use of the resources available. I have already alluded to some of these when replying to the previous question. The HSE acknowledges the need to accelerate the process of health care reform and through the use of initiatives, such as the national clinical care programmes, to move to models of care across all programmes delivering services to patients and clients at the lowest level of complexity and the least possible unit cost. I hope to minimise the impact on services but the reality is that we are in very challenging times and there will be a consequence for every programme. We will work in tandem with the HSE, the unions and our staff to find ways of changing how we do our business while minimising the impact on service provision.

Joan Collins (Dublin South Central, People Before Profit Alliance)
Link to this: Individually | In context

People outside this House who will hear this reply will not be confident that there will be a better or more efficient health service in the future. A total of €868 million has been taken out of the health service in what is already a crisis. People generally and in my constituency believe services are collapsing around their ears. What has happened is that services have been cut to the bone and the cuts are now eating into the marrow. There are still up to 365 patients on trolleys, huge waiting lists and hospitals are trying to get patients back into community care services. However, there is a lack of care services in the community. When stroke victims who receive very good care in acute hospitals move back into the community they cannot access services as the system is not working. People do not believe it is working. We need further direction from the Minister who says he is guiding the health service into a better position, but that is not happening.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

With respect, the system is working. Let us look at the facts, rather than the rhetoric and hyperbole. Perhaps the Deputy missed the point made, but the figure will be €750 million, not €868 million, as I explained to Deputy Ó Caoláin. I disagree that the service has collapsed and I stand over this assertion. The trolley count, week after week and month after month up to August last year, was 30% higher than in the preceding year. The special delivery unit, SDU, headed by Dr. Martin Connor, was formed in June and became operational in September and week on week the numbers have fallen since. Up until the last third of December, the trolley count was approximately 40% lower than in the previous year. That is a 70% turnaround in a matter of four months which I see as cause for cautious optimism, although l know we could run into serious problems and the trolley count could rise significantly again. Nonetheless, the initiatives taken by the SDU and hard-working doctors and nurses working in a different way in hospitals with support from management are yielding results. The great thing about the hospitals I have been to around the country is that the staff are buying into this. They now realise that instead of there being command and control from the centre, they are receiving support from the centre.

Joan Collins (Dublin South Central, People Before Profit Alliance)
Link to this: Individually | In context

Is the Minister saying that with a further €1.5 billion in cuts we will deliver a much-needed service, despite more people needing access to hospitals and some 3,000 health care workers being taken out of the system? He has mentioned the reduction in the trolley count, but we have heard from those on the ground that patients are being taken from accident and emergency departments to wards to pretend that there is not the same volume in traffic. This has been reported as true by workers on the front line. We can play with the figures which can always be played with, but those on the front line tell us about patients waiting in emergency departments, for access to hospitals, community care services and occupational therapists to help them to return to their homes. The only way they can receive that care is by going to private occupational therapists, in the process putting more pressure on ordinary working people. The Minister can play with the figures, but the reality is not as he states it.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

I said the Government's health policy would be based on evidence based information. I challenge the Deputy to go to the Irish Nurses and Midwives Organisation trolley count site and measure the results. The figures indicated have been agreed by the organisation and us. There is a dispute in one or two areas because, as happened today in particular, there was an alarming difference between our count and that of the organisation. It is being investigated. However, the figures this time last year were far greater. On the first Wednesday of the new year last year there were 569 patients lying on trolleys; this year there were approximately 325, which is still too many.

The Deputy asked whether a further reduction of €750 million in the health budget would help; of course, it would not. However, I can tell her - time has proved this - throwing money at the problem, in the way the previous Government did, would not fix it either without basic reforms. These reforms are now being introduced.

Last June and July we asked that no one be left waiting for longer than 12 months for an inpatient procedure. At the end of December 2010 there were 14,000 such patients. Our target was met everywhere, with just one exception, Galway, which is receiving special attention. The target this year will be a wait of nine months and I expect it to be met. I will offer my support in this regard.

In agreement with the Irish Nurses and Midwives Organisation, we examine an arbitrary figure at 8 a.m. and again at 2 p.m. and 4 p.m. in order that we can predict what will occur the next day and take action to avoid problems experienced in the past. By the middle of this year, we will have moved to a six hour target. For 95% of patients, the time which should elapse between their arrival at an emergency department and discharge or admission is six hours. We want 100% of them to be discharged or admitted within nine hours. That would be real progress, but we have not succeeded absolutely; the 350 waiting on trolleys are 350 too many.