Billy Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

27. To ask the Minister for Health his views on whether the €9 million additional funding for the expansion of existing services or the provision of new services in acute hospitals is adequate to demand; and if any of this funding is now likely to be used for other purposes in view of the HSE decision not to appeal the 2015 ruling of the Employment Appeals Tribunal on consultant contracts. [4907/17]

Billy Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I wish to ask the Minister for Health for his views on whether the €9 million additional funding for the expansion of existing services or the provision of new services in acute hospitals is adequate to meet demand. Is any of this funding now likely to be used for other purposes in view of the HSE's decision not to appeal the ruling of the Employment Appeals Tribunal on two consultant contracts?

Simon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank Deputy Kelleher for his question.

In order to respond to increasing demand for hospital services, budget 2017 provides an additional €118 million for hospital services in 2017. Of this funding, €109 million will be used to maintain our existing level of service to take into account the costs associated with our aging demographics, meeting increased demand for medicines, medical technology, and new procedures in hospitals. We would be criticised if we did not take these matters into account.

This funding will also provide for the costs associated with the restoration of payments to staff under the Landsdowne Road Agreement. Therefore it is €118 million extra for hospitals in 2017 with the bulk of that allocation going to dealing with demographics, medical technology, procedures and the Lansdowne Road restoration payments for staff doing important front-line jobs in our health service. As a part of that €118 million, €9 million has been allocated to expand existing or develop new acute hospital services this year. In order to increase capacity in our acute hospitals, €1.4 million of that has been allocated to open a new emergency department in University Hospital Limerick, and a further €1 million has been allocated to the opening of a new 75-bed ward block in University Hospital Galway.

The setting of budgets for individual hospitals and hospital groups, including the allocation of the remaining €6.6 million of new development funding, is currently being finalised by the HSE as part of the development of hospital group operational plans. New developments to be funded from the €6.6 million include additional ICU and HDU beds at Cork University Hospital, cardiology services at Waterford University Hospital, phase 2 of a new AMAU for Portlaoise Hospital, implementation of the new cancer strategy, which we should hopefully publish later this month, and implementation of the all-island paediatric cardiology service.

My Department is currently engaging with the HSE with respect to finalising the funding allocations associated with these new developments. The 2017 HSE national service plan outlines the HSE's need during 2017 to continue to pursue increased efficiency, value for money and budgetary control in delivering safe and effective healthcare services within its budget allocation. The HSE's decision not to appeal the 2015 Employment Appeals Tribunal ruling on consultant contracts will not impact on new development funding. The Employment Appeals Tribunal award will be met from existing resources and finance allocations. My colleague, the Minister for Public Expenditure and Reform, has set out the broader context for that.

Billy Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

It is extraordinary that in the overall budget the Minister talks about €459 million in headline figures and €180 million to address the ageing demographic profile in our acute hospital system. However, when one strips it all away we are talking about €9 million of additional funding to expand services. In other words, therefore, it is €9 million moving beyond where we currently are.

By any stretch of the imagination, that will have a profound impact on the capacity of hospitals to cater for what will happen in the year ahead. It is already transpiring. There are 601 people on trolleys today, 1 February 2017. It is the third highest figure in the history of the State. That is where we are. The idea that we can continue to say we have an expanded budget to cater for additional demand is wrong. The Minister must know in his heart and soul given the budget passed last year that the HSE service plan is already now a mythical creature. As we stand here on 1 February, we know we will have continued waiting lists, outpatient and inpatient, and people on trolleys because of inadequate funding for the acute hospitals system.

Simon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

That is entirely incorrect. In the past, Opposition spokespersons on health would have been very critical of a HSE service plan that did not adequately set aside resources for demographics. We cannot talk about existing levels of services as though that does not impact on people. This is about trying to prepare the health service for the fact that more people will need health services next year and the year after as our population both grows and ages. Before we start adding additional services, I have a duty as Minister for Health to ensure that we fund adequately existing levels of service based on demographics. Words like "mythical" which the Deputy used would much more appropriately apply had I closed my eyes, blocked my ears and pretended there were no demographic pressures.

As the Deputy knows, there is much more than €9 million in the budge for developments for health services when one goes beyond the acute hospitals sector. I note the area of mental health, which is my colleague, Deputy McEntee's area. Deputy Kelleher referred specifically to waiting lists and we have the first ring-fenced budget for waiting list initiatives since the onset of the recession. I know Deputy Kelleher is very supportive of those initiatives and, indeed, proposed many of them. Funding for extra disability services has also been provided. As such, it is not just €9 million for new services. It is €9 million out of €118 million more for the health service in our acute hospitals sector and there are many more developments in primary and social care also.

Billy Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I am trying to be helpful to the Minister by highlighting the deficiencies in the HSE service plan and the inadequate budget provided to him by the Government for health care in our acute hospitals system. This is primarily about the acute hospitals system itself. An additional €118 million is being made available to deal with the Lansdowne Road agreement and demographics. They are costs that should always be factored into the HSE service plan. For a number of years, the demographics were not being factored in. I accept that. However, in the context of new and additional treatments, procedures and service expansion beyond the demographic assessment, only €9 million is there. That will not deal with anything other than that which has already been assessed as going to come through the doors of hospitals due to demographic pressures. That is the reality. All that the Minister is providing for additional services above and beyond the demographics and the Lansdowne Road obligation is €9 million.

Simon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I appreciate Deputy Kelleher's helpfulness but that is simply not the case. For whatever reason, he is ignoring the reality that in addition to that €9 million, €20 million has been provided specifically for the NTPF to drive down waiting lists to more acceptable, albeit still high, levels by October 2017. It is intended to have no one waiting longer than 15 months for any procedure, whether inpatient, outpatient or day case. The Deputy is ignoring the fact that there is funding in the budget for 1,000 additional nurses. If we want to improve services in our acute hospital setting and across the health service, we need more nurses. The Deputy acknowledges the need for a bed-capacity review, on which we agree, and the work being undertaken to have it ready for the mid-term capital review. If we are serious about breaking the cycle of overcrowding that every Minister for Health has experienced in the last two decades, we will have to do something different on bed capacity. The Deputy's response ignores the fact that we are working actively and have started engagement on a new GP contract instead of operating off a 44 year-old contract which is out of date. A new GP contract will actually shift services decisively from the acute hospital setting into primary care. As such, there is a great deal more in the HSE service plan than just €9 million in addition.