Written answers

Thursday, 14 December 2017

Department of Health

Health Services Expenditure

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
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400. To ask the Minister for Health when multi-annual plans and budgets for health expenditure both current and capital will be brought forward. [53851/17]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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The Programme for Partnership Government set out the Government's intention to work with the Oireachtas to sustain appropriate annual increases in the Health Budget. Expenditure is to be based on multi-year budgeting supported by a five year Health Service Plan based on realistic and verifiable projections; at present, the Health System is not in a position to make realistic, verifiable projections using a “bottom up” approach. The Department is currently considering how best to practically implement this commitment and work is on-going in the development of the different elements required, and there are some existing building blocks already in placeincluding:

(i) Planning for Health – Trends and Priorities to Inform Service Planning

The HSE publishes a report titled “Planning for Health – Trends and Priorities to inform Health Service Planning” on an annual basis.

(ii) ESRI Medium-Term Projection Model of Healthcare Demand

Important work is currently underway as part of the joint Department of Health/ESRI Research Programme in Healthcare Reform that will assist in achieving the objective of introducing multi-annual budgeting supported by a 5 year Health Service Plan.

(iii) Activity Based Funding

Since January of 2016, funding for inpatient and daycase activity in the 38 largest public hospitals has been on an ABF basis. Hospitals are now given fixed ABF allocations, with any funding associated with inpatient and day case activity effectively being withdrawn, and subsequently earned back following delivery of agreed ABF activity targets, up to a maximum of the fixed ABF budget. Performance in this regard is monitored on a monthly basis.

(iv) Other Initiatives

Other important initiatives in this regard include work relating to the community costing programme, the development of a new model of care for the health service and the Bed Capacity Review.

In the meantime, in the context of the annual Estimates process, the HSE are undertaking work on Budgeting and Service Planning for 2018 and, as with previous years, the National Service Plan for 2018 is expected to be published in December 2017.

(v) Capital funding

The Exchequer Capital Envelopes 2018-2021 and outcomes of the Mid-Term Review of the Capital Plan were published in the context of Budget 2018. Health capital funding for 2018 was outlined in the recently published Public Service Estimates for 2018 and the HSE is currently developing its Capital Plan for 2018-2021.

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