Terence Flanagan (Dublin North East, Independent)
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236. To ask the Minister for Health his views on the changes, trends in the Health Service Executive service plan 2014 versus 2013, 2012 and 2011; and if he will make a statement on the matter. [3410/14]

James Reilly (Dublin North, Fine Gael)
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The HSE is legally obliged to set out the type and volume of health services it proposes to deliver in its annual National Service Plan (NSP). The preparation and publication of the HSE's annual Service Plan in each of the years 2011 to 2014 has taken place against a background of significantly reduced financial and human resources as a direct consequence of the very significant deterioration in the public finances that the State has had to contend with in this period. The resultant financial constraints has necessitated reductions in health service spending of over 20%. The numbers employed across the HSE have reduced by over 14,000 in this period.

The HSE has, in each of the years from 2011 to date, continued to focus its efforts on minimising the impact on front line services by utilising new, innovative and more efficient ways of using reducing resources. The delivery of services has, as a consequence, focused on the dual challenge of protecting patient outcomes while, at the same time, reducing costs. This has required increasing emphasis on models of care that treat patients at the lowest level of complexity and provide safe quality services at the least possible cost.

Despite these resource reductions the annual HSE Service Plan has managed, to a very significant extent, to maintain core service levels while also supporting growing demand for its services arising from population growth, increased levels of chronic disease, increased demand for drugs, higher numbers of medical card holders (up by 590,000 since 2008) and new cost intensive medical technologies and treatments. Additional funding has also been invested over this period to meet a range of critical service needs, and areas such as primary care and mental health services have benefitted from this funding. The roll out of such initiatives as the National Clinical Care Programmes and the Special Delivery Unit initiatives are also delivering greater value for money and productivity.

In this regard, the 2013 edition of Health at a Glance published by the OECD shows that Ireland continues to make substantive headway in improving health outcomes. Mortality due to cancer fell by 21%, ischemic heart disease by 59% and cerebrovascular disease by 54% between 1990 and 2012 and in all three instances the rates of improvement in Ireland were above the OECD average. Life expectancy in Ireland has increased by a full four years since 2000 to reach 80.6 today, again above the OECD average. 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 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 men and women who deliver our health and social care services are to be complemented for maintaining and, in many cases, improving the ever expanding range of services provided to the general public despite such reduced resources over the past four to five years. Their efforts have been highly commendable in these most challenging of times.