Peadar Tóibín (Meath West, Sinn Fein)
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Question 21: To ask the Minister for Health the manner in which the bulk of the reductions in staff, pay costs and efficiencies that the Health Service Executive is required to deliver in 2012 will increasingly impact directly on front line services in 2012, as stated in the HSE national service plan 2012; and if he will make a statement on the matter. [8323/12]

James Reilly (Dublin North, Fine Gael)
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The HSE National Service Plan 2012 sets out the health and personal social services that will be delivered by the HSE within its current budget of €13.317bn and identifies a cost reduction target in 2012 of €750m. The Service Plan reflects the Programme for Government commitments for health and the savings targets set out in the Comprehensive Expenditure Report 2012-2014.

The scale of the financial challenge facing the HSE means that there will be an inevitable and unavoidable reduction in services but it will not be a "straight line reduction". In developing the Plan, my Department and the HSE undertook a rigorous examination of budget allocations across the care programme areas, with the explicit aim of reducing the impact on frontline services and identifying where efficiencies will be driven. This process involved re-prioritising funding to protect areas of greatest need and meet Programme for Government commitments.

Planning for the impact of the end of the "grace period" began last autumn and a formal transition team for the health service is in place, chaired by an Assistant Secretary from my Department, comprising key HSE national and regional directors. Contingency plans have been developed locally for hospital and community services, reflecting risk assessments undertaken by each hospital/community manager. These have been reviewed at regional and national levels to ensure appropriate contingency measures are in place across all services.

I am satisfied that suitable arrangements are in place at national, regional and service specific levels to proactively manage the impact of staff exits on front line services. The focus is on protecting and maintaining critical front line services such as Emergency Department, maternity, critical care and neonatal services.

The mitigation measures which are in place include the backfilling of certain critical posts. However, the main focus is on reform and achieving greater productivity. The National Clinical Programmes are already delivering improvements in day of surgery admission rates, increases in the proportion of care that can be delivered on a day case basis and other productivity improvements designed to provide a better quality service to patients at less cost. I very much welcome the clinical leadership that is being provided in this regard. I also want to acknowledge and welcome the improvements in productivity that are being delivered by staff at local level through the Croke Park agreement in relation, for example, to staff redeployment, streamlining of management structures including clinical management roles, changes in skill mix and more cost effective rosters.

It is clear that 2012 will be a very challenging year for the health services. The Service Plan commits the HSE to minimising the impact on services by fast tracking new, innovative and more efficient ways of using reduced resources. It reflects the need to move to new models of care across all service areas which will treat patients at the lowest level of complexity and provide quality services at the least possible cost. The Plan will be implemented in the context of the significant new governance structures for the health services which I recently announced.