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‘Significant management challenge’ for health service – HSE DG

Speaking today at the launch of the HSE Service Plan 2017, Mr Tony O’Brien commented: “The health service continues to deliver its services in an environment where the population is growing, the number of people seeking to access services is higher than ever before and where public expectations for quality services continue to increase. There will be an ongoing and significant management challenge to balance demands and needs within the funding available to the HSE.”

Pointing to a predicted population increase overall of 0.7 per cent between 2016 and 2017 (with this projected to increase overall by 4 per cent by 2022), Mr O’Brien stressed that there would be an anticipated rise of 3.7 per cent in those aged 85 years and over. While noting that growing older in continued good health and independence was the goal for all, the inevitable increase in demands for services and assistance added greater demands and pressures for increased and expanded services.

The 2017 National Service Plan, published today following approval by the Minister for Health, Simon Harris, details the delivery of health services in 2017.

According to the HSE, it provides for a total funding level of €13,912 million for the delivery of health and social care services in 2017, representing an overall increase of €458.6 million (3.4 per cent) when compared to 2016. This includes €36.5 million to fund new service developments.

Separately a provision of €439 million is available in capital funding in 2017, comprising €384 million for building, equipping and furnishing of health facilities, with a further €55 million for ICT.

The provision of €81.3 million to expand and develop services includes €9 million for the Acute Hospitals Division; €1 million for the National Ambulance Service; €12 million for Primary Care; €1.5 million for Social Inclusion; €15 million for Mental Health; €11.8 million for Disability Services; €10 million for Services for Older People; €20 million for PCRS.

A total of €118.1 million has been provided for pay rate funding. This is provided in respect of the growth in pay costs associated with the Lansdowne Road Agreement (LRA), Labour Relations Commission recommendations and “other pay pressures”, according to the HSE. “It is provided to offset the increased cost of employing existing levels of staff and does not allow for an increase in staff numbers,” stated the Executive.

The HSE said it will prioritise its requirement to plan for an overall breakeven position by year end. “However, pressures exist in a number of areas and, similar to previous years, it has not been possible to identify a contingency amount that can be held in the event that costs exceed planned activity. It is therefore not expected that overruns in one area can be offset against surpluses in other areas to any great extent beyond what has already been factored in,” according to the Executive.

Amongst the priorities identified by the HSE for 2017 are the improvement of the quality and safety of all services. A three-year patient safety programme will see the implementation of a revised Integrated Risk Management Policy and the strengthening of accountability, stated the HSE.

Within the Acute Hospital Division, an additional 26,881 new presentations to ED are expected in 2017. The HSE said it will “continue to drive” the implementation of the ED taskforce plan recommendations in 2017 with a target of 5 per cent improvement in total time patients wait (Patient Experience Time) – aspiring to a 100 per cent compliance level. There will be a further focus on eliminating those waiting over 24 hours before admission, it said.

Other areas of development in 2017 will include improved access to diagnostic services, the opening of the University of Limerick Hospital ED and the extension of opening hours in Smithfield Rapid Access service.

Inpatient discharges are also expected to rise with 12,600 more people expected to be seen. A new 75 bed replacement ward block will be opened in Galway University Hospital, while phase two of a new Acute Medical Assessment Unit will be opened in the Midland Regional Hospital Portlaoise. Services for complex paediatric care at home will be increased next year, while children who are in receipt of domiciliary care allowance with be provided with medical cards. Children up to 12 years will be offered a GP visit card.

The HSE said it will continue to work with the National Treatment Purchase Fund in relation to the allocated funding of €15m aimed at addressing waiting lists, reducing waiting times and providing treatment for those patients waiting longest through outsourcing.

A new National Women and Infants Health Programme will be established in 2017. This programme will develop an action plan for the implementation of the National Maternity Strategy and provide high level co-ordination of maternity, gynaecology and neonatal services nationally, stated the HSE.

Within mental health services, there will be significant focus on Youth Mental Health in 2017, “with improvements in out of hours liaison and seven day responses”.

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