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Unfunded activity, new drug costs and superbugs among ‘risks’ to HSE Service Plan 2018

The HSE Service Plan also says the health service model that is “no longer fit for purpose and cannot meet the needs of our citizens now and into the future”.

The 2018 budget of €14.5 billion represents an overall increase of €608 million (4.4 per cent) compared to the 2017 allocated budget allocation.

The Service Plan described the additional level of funding as welcome. However, it stated that the growing cost of delivering core health and social services is such that the HSE faces “a very significant financial challenge in 2018 in maintaining the existing level of services”. It is estimated that there will be a “financial challenge” within the operational service areas of approximately €346 million brought about by an ever increasing older population, increased demand for services, rising costs – including workforce, new and existing drugs, and regulatory requirement costs – and a health service model that is “no longer fit for purpose and cannot meet the needs of our citizens now and into the future”.

Commenting on the cost pressures, Mr O’Brien added: “As we seek to grow our service levels to a greater extent than our resources are growing, we must continuously strive for operational efficiencies. This is the sign of a mature and ambitious health system that is doing everything it can to deliver the maximum volume of services to patients and service users within the budget we have to work with.”

The HSE said the additional investment for 2018 has allowed it to make a number of “significant investments” in new services next year, including: An investment of €9 million to support the expansion of paediatric/adolescent orthopaedic services including scoliosis; €25 million in primary care to support the GP contract, GP training, diagnostics, therapies, nursing, Advanced Nurse Practitioner appointments and community nursing; €15 million in mental health to support a range of key service developments; and €10 million for respite care, providing support in 2018 to 400 individuals with a disability and their families.

A total of €40.2 million will be invested in acute hospital services. The HSE will be using this funding to improve access to critical care services along with investment in services for people with spina bifida and spinal conditions. Women and infant health services will be expanded through increased scanning and gynaecology services, it said.

Cancer services nationally will receive a total of €5.5 million and this will allow for the expansion of services including radiotherapy treatment. “This funding will provide ongoing investment in cancer drugs and with the numbers of patients now surviving their cancer following improved treatments and services, there will be further investment in the ongoing care for those who are surviving cancer,” stated the Executive.

Next year will also see an extra investment of €32 million in additional home support, transitional care and bed capacity in rehabilitation settings. Home support and transitional care will be increased over the full year.

Within primary care, an additional investment of €25 million will allow for the expansion of Community Intervention Team support and OPAT support (IV care in patients’ homes). This will mean an extra 4,682 referrals. For children being discharged from hospital, the HSE will provide an additional 60 home care packages representing an investment of €2.1 million. There will also be “improved access to Occupational Therapy Services, an expansion of the GP out-of-hours service and the commissioning of 15 additional primary care centres, with an investment of €10 million”.

An additional €6.5 million will be invested in addition services, with €1.5 million in homeless services along with €1 million in primary care services for refugees in emergency reception and orientation centres.

Speaking at today’s launch, Mr O’Brien commented: “For several years we have been aware of the need for a shift in health service delivery in order to move from the more traditional focus of treatment and cure, to that of prevention and treatment, when required. The challenges referenced in this service plan are recognised fully in the recent Sláintecare report, which signals a new direction of travel in relation to eligibility, delivery, and funding of health and social care in Ireland into the future.

“The cross-party support for Sláintecare presents a huge opportunity and, appropriately resourced and governed, it has the potential to transform the health and wellbeing of the population, and how and where they access services.”

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