HSE warns of issues delivering services with €14bn budget

The Health Service Executive has published its €14 billion service plan for 2017, which provides just €36.5 million for new service developments.

A further €439 million is being provided for capital developments, primarily the new national children’s hospital.

A total of €118 million has been set aside for extra pay costs but there is no specific provision in the plan for the cost a new GP contract, which is currently under negotiation.

The plan promises a 5 per cent improvement in patient waiting times in emergency departments and the elimination of waiting times of over 24 hours.

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There were 536 patients waiting for admission to hospital on Wednesday morning, one of the highest levels of overcrowding seen this year. In Cork University Hospital alone, there were 60 patients on trolleys.

In the plan, the HSE warns the Government its budget for 2017 may not be sufficient to meet all the competing demands, including replacing ageing medical equipment and costs of new drugs.

Significant risks

Director general Tony O’Brien warns of a number of significant risks to the delivery of services next year. He says there may be difficulties in controlling pay and staff numbers and balancing those costs with specific “safety, regulatory, demand and practice-driven pressures”.

Mr O’Brien also advises the number of people availing of medical cards will be a challenge. The plan provides for 24,000 fewer medical cards as employment rates increase but an additional 50,000 GP visit cards.

“There are a number of risks to the successful delivery of National Service Plan 2017. While every effort will be made to manage these risks it may not be possible to eliminate them in full, and they may impact on planned levels of service delivery or achievement of targeted performance.”

The population is forecast to rise by 0.7 per cent next year, while the over-85 population will grow by 3.7 per cent, he points out. This will inevitably put services under pressure.

Particular management focus will be required in a number of areas, Mr O’Brien says, including increased demand for services.

The HSE director general says the organisation needs to invest in infrastructure including replacing ageing medical equipment and meeting the demands for new drug approvals.

This will be a struggle within the funding levels allocated by the Government for 2017 he warns.

Medical cards

New developments planned for next year include a 75-bed block at Galway University Hospital, a medical assessment unit in Portlaoise hospital and the provision of medical cards to all children in receipt of domiciliary care allowance.

Mr Harris says the budget allocated to the health service is the largest in the history of the State and represents an increase of €458.6 million on last year’s allocation.

Despite the additional money, the reaction from health service unions was negative.

The Irish Medical Organisation claims insufficient funds have been put aside to deal with hospital overcrowding, increasing waiting lists, vacant consultant posts, emigration of doctors and under-resourced GP services.

The National Association of General Practitioners (NAGP) says the HSE’s professed commitment to primary care is not reflected in the plan, as the budget increase for hospitals is four times that provided for primary care.

The Irish Hospital Consultants Association say the 2.8 per cent increase in the acute hospital budget is “inadequate and completely insufficient” to cater for existing patient demand.

Age Action is also disappointed; it says the HSE will provide fewer home help hours to fewer people than it did six years ago, despite rapidly growing demand.

Under the plan €4.4 billion will go towards hospital services, with €3.8 billion earmarked for primary care.

A total of €3.3 billion will be spent on disability and services for older people while €853 million will go towards mental health services.