The health service will have to find €230 million in cuts next year despite a small overall increase in funding, according to the 2015 service plan of the Health Service Executive.
The net increase in funding for next year is €115 million, or 1 per cent of the total budget, the first time in seven years that extra money has been made available to fund health services.
The HSE has been told to achieve minimum savings of €130 million next year to fund "unavoidable cost pressures" and specified improvements in services.
However, in addition to this, HSE director general Tony O’Brien said the service was facing a further “residual financial challenge” of €100 million which would have to be addressed.
“The additional funding provided will support the HSE in maintaining existing levels of service. It will not, however, be sufficient to fully address the increasing demands being placed on our hospital system, in particular the growing waiting lists for elective admissions.”
Minister for Health Leo Varadkar invoked the parable of the loaves and fishes, saying there was not enough funding to satisfy everyone. “I think it is important to be upfront and honest about this plan. It is based on maintaining the existing level of service plus some targeted improvements. We do not have sufficient funds or the right system in place to solve all of our problems or meet all of our priorities.
“Moreover, any increase in demand for services next year will inevitably impact adversely on waiting lists.”
Some additional “service pressures” will have to be addressed in future years, after 2015, he warned.
Performance demands
A “score card” system for measuring managerial performance is to be introduced, with disciplinary sanctions threatened for significant or persistent underperformance.
Areas which will benefit from extra funding include dealing with delayed discharges (€25 million), mental health (€35 million) and disability services (€20 million). The service plan provides for an extra €55 million for ICT, in recognition of the HSE’s problems with computer systems.
The number of hospital patients whose discharge has been delayed because no care is available for them at home or in a nursing home has risen to 850, Mr Varadkar revealed.
A €10 million increase in the Fair Deal budget will provide an additional 300 places and €8 million is being spent on 115 additional short-stay beds around Dublin. Half of these will be in the old Mount Carmel hospital, due to reopen soon as a community facility. The objective is to reduce waiting times from Fair Deal from 15 weeks to 11 weeks.
Stroke services are being extended with additional midwives and consultants appointed to maternity units and GPs will get greater access to diagnostic services such as ultrasound.
Other areas to benefit from funding are renal dialysis, spina bifida, hepatitis C drugs and hip screening.
Free GP care for under-sixes will be introduced next April at a cost of €25 million, while €10 million will be spent on extending free GP care to all over-70s.
