The HSE must move away from the assumption that additional resources are always needed for the delivery of new initiatives, the Minister for Health has said.
Jennifer Carroll MacNeill said the HSE can and must demonstrate better outcomes within budget through the smarter use of existing staff, infrastructure and funding.
In her annual policy direction to the health service, she said she was mandating the new HSE regions to “shift care from hospitals into the community”. She said she was enabling “flexibility of funding from acute services to the community, not the other way”.
The Minister said staffing allocated to community services should be “proportionally higher than staffing allocated to acute hospitals”.
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She also wants the HSE to tackle existing inconsistencies in the provision of health services between different regions.
“In some areas patients are seen quickly; in others access is slower. Meanwhile, services such as community therapies face severe backlogs, even in health regions that perform well in other areas.”
“The South West Health Region consistently meets targets for access to lung rapid access cancer clinics, while showing mixed performance for breast and prostate. The same region has among the longest primary care therapy waiting lists.”
“The West/North West Health Region generally performs well for access to adult mental health services, and has made progress in access to diagnostics, but continues to report very long waiting times for access to surgery and neurology outpatient services, exceeding 12 months in several hospitals.
“Some Dublin hospitals are leading with strong access in certain areas but have significant outpatient backlogs, eg tens of thousands waiting for first outpatient appointments in the Dublin and North East Health Region and the Dublin and Midlands Health Region.
“These contrasts show that excellence is possible – but not yet consistent,” the Minister told the HSE in her annual letter of determination, which sets out funding and her priorities for the year ahead. This letter forms the basis of the HSE’s annual service plan which was published on Monday.
The Minister said she wanted the HSE to deliver on a permanent basis cumulative savings of up to €633 million that were set out in the organisation’s budget for 2025.
In addition the Minister said the HSE must generate additional savings of €181 million in the year ahead.
Ms Carroll MacNeill said the HSE needed to produce a plan to reduce spending on staff provided through employment agencies to less than €720 million next year.
The Minster said the HSE can and must demonstrate better outcomes within budget through smarter use of existing staff, infrastructure and funding. She said this meant tackling inefficiencies, streamlining decision-making, reviewing and reforming processes and embracing innovation and technology.
“New development funding is normally around 0.5 per cent of total health budget. In the past there was a view that new funding streams were the only way to improve or enhance services. This fails to recognise the totality of health investment over the past decade and the capacity of any service to organise itself better with existing and additional resources to provide better service,” Ms Carroll MacNeill said.
The Minister said while there had been progress made, she remained concerned at the number of patients deemed to require admission to hospital who were cared for on trolleys. She said she wanted reforms to the system of targets for hospitals.
