Tánaiste and Minister for Health and Children, Mary Harney, T.D. announces Health Estimate 2006
Disability services, new Hospital Units and Primary Care to benefit from over €1bn increase in health current funding in 2006
17 November 2005
The Tánaiste and Minister for Health and Children, Mary Harney T.D., today announced overall funding of €12.640 billion for the health services in 2006.
An underlying increase* of over €1bn is being provided in the Estimates today. An increase of almost €990 million in the Health Service Executive’s non-capital Vote represents an underlying increase of 9.25% over 2005.
* See note at end on adjustments to reflect once-off items, e.g. HSE accounting requirements
The Tánaiste said, “I am very pleased that we are again able to prioritise significant health service developments today in these Estimates. I am determined to ensure that major funding increases translate into visibly better services for patients.
“Our ability to make these substantial funding increases arises directly from the performance of the economy and the sound economic policies adopted by the Government over many years.
“There are few countries that can provide health spending increases of more than three times the rate of inflation and well above the GNP growth rate. Ireland has moved from a country spending almost 15 per cent less than the OECD average for total health spending in 1997 to a country spending 17 per cent above the average in 2003. We can only continue to fund new services at this level if we secure continued, strong economic growth.
“I am also determined that the pace of health reform across the board matches the pace of funding increases. This is the key to ensuring better services, better value for money and taxpayers’ support for further health spending increases.
“2005 has been a year of major transition as we established the Health Service Executive. We are already beginning to see the value of this fundamental reform in terms of accountability and decision-making. The HSE has both management and financial responsibility for our health service operations.
“The HSE and my Department have worked together to efficiently use resources in improving the delivery of health services in this country. The challenge for 2006 is to ensure that the additional funding provided to the Health Sector for next year is once again, effectively and efficiently employed to build on the successes of 2005.
“I look forward to working closely with the HSE to ensure health policy, health funding and health operations are all aligned to the best interest of patients in our country.”
The increased funding will be allocated to the following priorities in 2006:
- €100 million for Disability and Mental Health services
- Within this, €59 million to support and enhance the developments in the Disability services achieved following funding received in Budget 2005. This will allow for increases in the numbers of residential, respite and day places and home supports for people with intellectual, physical or sensory disabilities, as well as additional community based mental health facilities.
- A further €41 million will also be assigned to the Disability and Mental Health Sector to improve the range of multi-disciplinary support services available as well as addressing core funding and staffing issues. Within this the Tánaiste specified that she would be allocating €1.2 million to support the implementation of “Reach Out – National Strategy for Action on Suicide Prevention”.
- €60 million for the continued commissioning of a number of
new units in acute and non-acute hospital facilities. Current
funding is now being provided to follow recent capital
investment, so as to progress towards the opening of new beds
and treatment facilities throughout the country, including at
the following locations:
- St. Vincent’s Hospital, Dublin (including A&E; treatment / diagnostic facilities)
- St. James’ Hospital (day procedures)
- Midland Regional Hospital at Tullamore (new hospital development)
- Cork University Hospital (including maternity and day procedures)
- University College Hospital, Galway (cardiothoracic, ICU, radiotherapy, orthopaedics)
- Our Lady’s Hospital, Cashel (elderly mentally infirm, supervised residence/clinical accommodation and independent living units)
- Carndonagh (new dementia unit)
- Our Lady’s Hospital for Sick Children, Crumlin (MRI)
- St. Ita’s, Newcastlewest (new beds)
- Our Lady of Lourdes Hospital, Drogheda (A&E)
- Cavan General Hospital (theatre and ward fit-out)
- Louth County Hospital, Dundalk (modular theatres)
- Wexford General Hospital (additional acute beds)
- COPE foundation, Cork (intellectual disability support)
- €16 million for Primary Care Services next year will permit the appointment of additional frontline personnel to work alongside GPs in the improved delivery of community primary care services, an increase in the number GP training places and the further development of GP out-of-hours cooperatives. (See section below).
- Medical education:
- €9 million for Medical Education and Training, Integrated Children’s/General Nursing Degree Programmes and Clinical Placements in physiotherapy, occupational therapy and speech and language therapy. This will mean that there will be direct entry by school leavers into these specialist nursing degree programmes (see separate release).
- We are also now at the beginning of a process to double the number of medical places. The increase in 2006 will be 70 new places. The required funding to support this process in relation to clinical placements of students will be forthcoming from the Health votes in coming years.
- In additional and under separate funding, the number of GP training places will increase by a further 22 to 128. This is the second of three annual increases in the number, aimed at increasing the number of training places from 84 to 150 over three years and represents a significant commitment to responding to the future GP manpower requirements.
- Cystic Fibrosis Services: €4.78 million is being allocated to provide for additional specialist medical, nursing and allied health professional staff at Cystic Fibrosis Units around the country. This will include a particular focus on the national adult tertiary Cystic Fibrosis Centre at St Vincent’s University Hospital in Dublin. Cystic Fibrosis services at St Vincent’s Hospital are acknowledged as requiring significant investment in order to respond to patient needs and expectations.
- Additional funding of €13 million is to be provided to the National Treatment Purchase Fund to further reduce the waiting times for patients by increasing treatment capacity for both in-patients and out-patients by some 3,500.
- €8 million for overall child welfare and protection services and in particular in early intervention and prevention services, in respect of the implementation of the Children Act 2001.
- Additional funding of €2m in 2006 will enable further implementation of the actions in the National Traveller Health Strategy which are targeted at improving the health status of Travellers. This is a 38% increase on the total allocation for the period 2002 to 2003, and over €11m annually is now available for specific traveller health services. In particular the funding will be used to replicate Primary Healthcare for Travellers Projects and for the conduct of the Travellers’ All-Ireland Health Study which will commence in 2006 and which will inform the future direction of Traveller health services.
- Drugs and HIV services will receive additional funding of €3 million for the expansion of harm reduction services, the establishment of Tier 3 teams relating to the Under 18s report and the development of broader treatment services with particular emphasis on progression through treatment and responses to cocaine and poly-drug use. This additional funding also includes an €0.100 million for Open Heart House.
- €2 million has been provided for homeless services, specifically to meet the revenue consequences of the Dept. of the Environment’s NDP allocation for capital projects.
- €10 million to complete the stock-piling of anti-virals, for the purchase H5N1 avian flu vaccines and for the supply of vaccines should a flu outbreak occur
Primary Care
The government remains fully committed to the implementation of the principles set out in the National Primary Care Strategy and the additional funding provided in the Estimates today will enable continued development of primary care services. The largest proportion of the budget of the HSE is already being devoted to the non-acute, community based services. The additional resources made available now will be invested to ensure that they are focused on meaningful developments with maximum front-line impact. This should enable the HSE to appoint approximately 300 additional professionals to supplement approximately 75-100 existing teams bringing improved primary care services to almost 600,000 people by the end of 2006.
The government is committed to improving the level and quality of GP out of hours services. The additional funding in 2006 will allow for an additional 350,000 persons to be covered by comprehensive out of hours general practitioner cover. The HSE estimates that 2.4 million people are presently covered by the existing out of hours co-operatives. Thus the 2006 estimate will bring total coverage to approximately 2.75 million people or 70% of the population of the country.
Further details of allocations are as follows:
- Acute Hospital Services
- Cancer Services : €9 million towards the continued implementation of the National Cancer Strategy
- Renal Services : €8 million to support the cost of providing dialysis services, and a living related donor renal transplant programme.
- Neurology and Neurophysiology Services : €3 million to support the development of neurology and neurophysiology services.
- Obesity : €3 million to progress the implementation of the recommendations of the National Task Force on Obesity.
- Pre-Hospital Emergency/Ambulance Services : €2 million to meet the costs associated with the accelerated roll-out of the EMT-A training programme, the continued phasing out of on-call rotas for ambulance personnel, the further development of the national neo-natal transport programme, and the enhanced air ambulance services.
Other elements of the Estimates are:
- There are significant effects in 2006 of Sustaining Progress and Benchmarking for public servants in the health sector and a number of technical adjustments to the Health Votes. Pay costs form a very significant part of overall expenditure in a labour intensive sector like health. The pay-bill, inclusive of benchmarking, will require an additional €422 million in 2006.
- Further funding of €128 million is being made available to meet the increased cost of the Primary Care Reimbursement Scheme. This represents an increase of 9%. An addition of about €50 million is being provided for Demand Led Schemes in respect of the upward pressures on the schemes.
Capital
Capital funding of €578.5 million will be provided in 2005 to facilitate further improvements of health infrastructure nationally. This will allow progress through planning, construction or equipping stages for various projects and will also allow for continued significant investment in the important area of Minor Capital across all healthcare programmes (re-equipping, refurbishment, health and safety, fire precautions, maintenance, etc.). Such investment brings rapid and tangible benefits to both staff and clients using health facilities.
Hospital Charges
There will be an increase of 10% increase in the charges raised by hospitals from private beds. This income goes towards supporting services in public hospitals and is part, therefore, of their budgets. Even with this increase, the cost of providing services to private patients in the major hospitals remains significantly greater than the income from the private insurance companies, in many cases. In the interests of equity, it is Government policy to gradually eliminate the subsidy and relieve the general taxpayers of the burden of carrying these costs. The increase being implemented is aimed at closing that gap. There will also be an increase of €5 in the statutory in-patient bed charge, bringing it to €60 per night (to a maximum of 10 nights a year).
A & E Charges
Accident and Emergency charges are also being increased by €5 to €60. This increase will facilitate more appropriate attendances at A&E units by eliminating the incentive for people to attend these units when they might more appropriately receive services from General Practitioners.
The combination of bed charge and A & E increases will yield about €25 million a year.
Adjustment to Votes for once-off items
Several once-off items were included in the Revised Estimates for 2005 that should not be taken into account in assessing year-on-year health funding increases. These totalled €280m, including €216m to reflect the change from accruals accounting at the former health boards to the cash based accounting at the Health Service Executive. The underlying increase in health services current spending is over 9per cent.
