Health services provided with an additional €1.1 billion in the 2008 Pre-Budget Estimates to sustain services
18th October 2007
The Minister for Health and Children, Mary Harney T.D. today announced details of the 2008 Pre-Budget Estimates for the health services.
The Minister said:“Today’s Pre-Budget Estimates provide more than €1 billion extra revenue funding next year for the HSE to deliver our public health services, an increase of 7%. This is before any service development funding which will be announced on Budget day.”
“There is an across-the-board increase of 7% provided for each of the HSE regions, for hospitals and the GMS (medical card) scheme. This will sustain the substantial annual service increases that have been provided to the public in recent years [see Appendix 2].
“The 7% increase is 4 percentage points above projected growth in GNP next year. It is also similarly above projected average inflation for the period 2008-2010.
“We are fortunate that our economic performance supports this increase. It also demonstrates the Government’s continued commitment to public health service funding alongside the reform programme.
“In recent years, Ireland’s health spending has increased at one of the fastest rates in the world. Our health spending as a proportion of national income is now at the average for OECD countries, notwithstanding that our population is particularly young.
“Seven per cent growth is a substantial increase by international and any other standards to maintain existing service levels.
“Other developed countries do not, or cannot, provide for this level of increase, including their need to meet the cost of new services. Some provide for significant new service developments within this level of funding increase.
“Increasing the efficiency of our spending on health is therefore a high priority, as new funding is kept within sustainable limits.
“The challenge for our health services is to deliver existing and new services from a combination of sustainable new tax funding and the achievement of cost savings each year. The HSE is planning to achieve substantial savings next year, for example, on the total cost of medicines.
HSE Service Plan to set out details
The Minister explained that the next step would involve the HSE submitting its 2008 Service Plan for her approval. She said:
“The 2008 Service Plan will outline the type and volume of services which the HSE plans to provide within today’s pre-budget figure.
“The service planning framework for next year is being improved to establish clearer links between, on the one hand, the funding provided and employment ceilings authorised and, on the other hand, levels of service activity and the resultant delivery of measurable progress in implementing the Government’s policy objectives.”
“There have been significant improvements in the health of our population and there is clear evidence that the health services are delivering improved and increased levels of service to patients and clients. Continued extra investment coupled with reform will deliver even better results.”
This year, for the first time, the estimates cover only the updated cost of continuing to provide the “existing level of service”: all service development measures will be announced on Budget day. This is part of the move announced by the Tánaiste and Minister for Finance to a single Budget that presents both spending and taxation policy developments on the same day. The Minister said:
“I support the greater transparency inherent in the new approach and the focus which it brings to bear on evaluating what services are being delivered from within existing resources. The Government is investing enormous amount of money in our health services and we need to focus on securing maximum value for patients and taxpayers from this core funding. This is an integral part of the health reform programme.”
Further details attached.
Appendix 1
2008 Health Group of Votes announced in pre-Budget estimates.
Current expenditure:
Vote 39 (Department of Health & Children): An increase of €13m or 2.9% from €437m to €450m
Vote 40 (HSE): An underlying increase (i.e. excluding the nursing home repayment scheme) of €935m or 7%. When account is taken of projected savings of €150m in 2008 in the cost of medicines the true underlying increase is €1,085m or 8.3%. The nominal increase (including the repayments scheme and excluding the impact of the drug savings) is 5.2%.
Vote 41 (Office of the Minister for Children): An increase of €58m or 12% from €484m to €542m.
Capital expenditure:
The capital allocations announced today are exactly the same as the 2007 allocations. The full 2008 provisions will be announced in the Budget.
Additional information:
The increased allocation for the Department of Health & Children includes the standard pay and non-pay inflators together with follow-on costs in respect of BreastCheck.
The increased allocation for the HSE includes the standard pay and non-pay inflators (The projected cost of public service pay rate increases is some €325m). It takes account of trend growth in drug/medicine costs offset by projected savings from the revised pricing levels now in place for pharmaceutical manufacturing and distribution. It also includes a significant balancing element to cover a variety of other health cost drivers including demographics and health technology.
The increased allocation for the Office of the Minister for Children covers additional funding for the Early Childcare Payment in respect of the upward trend in the birth rate and migration. It also provides for a higher rate of expected take-up under the National Childcare Investment Programme.
According to the OECD, health spending in Ireland grew in real terms by an average of 9.1% per year between 1999 and 2004, compared to an OECD average of 5.2%. The increase announced today will maintain this upward trend.
Appendix 2
Improvements in health status and in the level of services being provided
Life Expectancy:
Life expectancy in Ireland has increased steeply since 1999 and the 2005 figures show that life expectancy at birth is 79.59, an increase of 3.5 years. As a result our life expectancy is now considerably higher that the new EU27 average.
Acute Hospitals:
Inpatient and Day Case Activity
To the end of August 2007, compared with the same period in 2006, all hospital groups are experiencing increased demand for in-patient treatments. Nationally, in-patient activity is almost 4% higher compared to last year and 2% above planned levels.
| Acute Services | Outturn 2006 | Target 2007 | Target Year To Date | Actual Year To Date | % Variance YTD Actual v Target | Same period YTD last year | % variance YTD v YTD last year |
|---|---|---|---|---|---|---|---|
| Inpatient Discharges | 592,269 | 597,135 | 397,545 | 407,682 | 2.5% | 392,818 | 3.8% |
Similarly, day case activity has increased by over 5% compared to last year and by 4% compared to planned levels of activity.
| Acute Services | Outturn 2006 | Target 2007 | Target Year To Date | Actual Year To Date | % Variance YTD Actual v Target | Same period YTD last year | % variance YTD v YTD last year |
|---|---|---|---|---|---|---|---|
| Day Case Attendances | 554,512 | 554,512 | 376,030 | 391,340 | 4.1% | 371,800 | 5.3% |
Births:
The maternity hospitals experienced unprecedented levels of activity to the end of August 2007. In the Rotunda Hospital, there were 855 births in August; a 28% increase on the monthly average of 668 for the first 7 months of the year. Total births for August were 6,389, compared to a previous high of 6,121 reported in July.
| Acute Services | Outturn 2006 | Target 2007 | Target Year To Date | Actual Year To Date | % Variance YTD Actual v Target | Same period YTD last year | % variance YTD v YTD last year |
|---|---|---|---|---|---|---|---|
| Births | 62,740 | 65,068 | 43,319 | 45,533 | 5.1% | 41,177 | 10.6% |
National Development Funding:
Since the start of 2005 the NDP funding has delivered:
- 247 additional Acute Hospital Beds
- 162 additional Acute Hospital Day beds
- 100 additional Acute Hospital Beds and 100 Admission Lounge places under the Winter Initiative Programme
NTPF Waiting Times
At the end of September 2007, the number of adults waiting for more than 3 months was 19,083 and the number of children was 2,320; a total of 21,403. For the most common procedures, adults and children tend to wait 2-5 months, compared with 2-5 years before the advent of the NTPF in 2002.
Services for Older People:
An additional €255m was allocated in Budget 2007 towards improving services for older people and palliative care for 2007. This is in addition to the €150m package that was put in place in 2006. In two years this Government had added over €400m to services for older people.
Almost three quarters of this is being allocated to develop further the community-based services that help older people remain in their own homes and for additional residential long-stay places for those who can no longer live in the community.
Home Care Packages
Investment of €110m since 2005 has provided for an additional 5,000 Home Care Packages. Approximately 10,000 clients have benefited from this initiative in the period January 2006-July 2007
Home Help Hours
Over 23 million Home Help hours have been provided for nationally since 2005, including an additional 780,000 hours in 2007. Over 19 million hours has been delivered to end August 2007.
Services for People with a Disability:
Between 1997 and 2006, additional revenue and capital funding of €851m has been invested in health funded support services for people with disabilities of which €549m was provided for persons with an intellectual disability and those with autism and €302m was provided for people with physical or sensory disabilities.
An additional sum of €75m for revenue purposes was provided for disability services in the 2007 budget. This sum incorporates the 2007 element of the Government’s Multi-annual investment programme for the National Disability Strategy, which is committed to providing some €900m capital and revenue funding over the period 2005-2009.
The €900 multi-annual investment programme for high priority Disability services, announced in the 2005 Budget, has created in excess of 500 additional residential places, over 200 additional respite places and 1,000 additional day places since 2005.
Frontline Staff:
There are currently almost 8,000 Medical/Dental personnel (an increase of 660 since end 2005); more than 37,500 nurses (an increase of 2,300 since 2005); and, almost 15,500 other Health professionals such as Speech and Language therapists, Physiotherapists; Social Care and Social Workers; Psychologists and Environmental Health Officers (an increase of almost 1,500 since 2005).
