Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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50. To ask the Minister for Health the mechanisms that are in place to assess the impact budget 2014 will have on the health, safety, quality of care and provision of services for patients in our public health system; and if he acknowledges the need to healthcare-proof this and all future budgets. [40029/13]

James Reilly (Dublin North, Fine Gael)
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The health care system has, over recent years, had to deal with a number of major challenges, including reduced overall levels of funding and employment levels, demographic pressures, and increased numbers of people with chronic illnesses.

Despite this, major improvements in mortality and morbidity rates have been achieved in certain core areas, including diseases of the circulatory system, where the death rate per 100,000 has fallen by almost 36% since 2002, and overall cancer rates, which have witnessed an 8% overall reduction in the same period. This has been achieved during a period when the average length of stay in acute hospitals has also reduced and the number of patients receiving the treatment they require without having to stay in hospital (that is day case patients) has increased as a percentage of total discharges by over 50%.

The 2013 Service Plan required the HSE to continue to focus its delivery of services on the dual challenge of protecting patient outcomes while, at the same time, reducing costs. 2014 will be no different in this regard and any measures impacting on the health system as a result of Budget 2014 will also be assessed against these criteria – with the outcomes of this consideration set out in the HSE’s National Service Plan for 2014, which will be submitted to me for approval within a matter of weeks of the Budget.

The National Service Plan, in setting out the operating framework for the delivery of HSE services throughout 2014, will look to deliver the maximum level of safe services possible, with prioritisation, where necessary, of certain services to meet the most urgent needs. The Plan will also set out targets in respect of each programme area to ensure that performance can be evaluated throughout the year in order to identify any emerging areas of concern, and, should any such concerns arise, implement necessary remedial measures without delay.