HSE Service Plan slammed by medical organisations

The Health Service Executive will have just over €81m to expand and develop new services next year

HSE Service Plan slammed by medical organisations

Director General HSE Tony O Brien and Minister for Health Simon Harris TD at the publication of the HSE 2017 National Service Plan. Image: RollingNews

Medical associations have slammed the HSE National Service Plan as inadequate, insufficient and underfunded.

The health body announced its national service plan for 2017 this afternoon - with the biggest health budget in the history of the state at almost €14bn.

It means there will be an increase in spending of over €458m this year - however much of the extra cash has already been accounted for and the plan provides just €36.5m to fund and develop new services.

A provision of €81.3m to expand and develop existing services will be split between The Acute Hospitals Division, Primary Care, the Ambulance Service, Mental Health, Disability Services, Social inclusion, Elderly Services and the Primary Care Reimbursement service (PCRS).

A separate capital funding provision of €439 has also been made available - with the lion’s share going to fund the new children’s hospital.

The plan has set aside €118m for the potential rise in pay costs associated with the Lansdowne Road Agreement (LRA), Labour Relations Commission recommendations and other pay pressures; however the money will be used for existing HSE staff and “does not allow for an increase in staff numbers.”

The executive is planning for nearly 24,500 fewer medical cards and more than 50,000 more GP cards next year.

As part of the plan, the HSE has announced it will hold a Christmas recruitment drive at the end of this month to try and attract nurses and midwives who have returned home for Christmas to fill the vacancies in hospitals.

Director General HSE Tony O Brien and Minister for Health Simon Harris TD at the publication of the HSE 2017 National Service Plan. Image: RollingNews

HSE director General, Tony O’Brien warned there are “a number of risks” to the successful delivery of services next year.

He said the health service is operating 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.

“While every effort will be made to manage these risks, it may not be possible to eliminate them in full and they may impact on planned levels of service delivery or achievement of targeted performance.”

The Irish Medical Organisation warned the health budget has been left with insufficient funds to address the problems in the Irish health service.

IMO President Dr John Duddy said the plan will offer no respite from the “carousel of hospital overcrowding, increasing waiting lists, vacant consultant posts, emigrating doctors and under-resourced GP services.”

“When the HSE itself starts pre-warning about budget shortages before the Service Plan is produced, you know you are facing a problem,” he said.

“Unfortunately, the HSE warnings are well placed this year and we have no confidence that patients will get the care and attention they deserve or that professionals will get the resources they require to do their jobs effectively.”

“Unless and until we address the problems of bed capacity the overcrowding we see in our Emergency Departments will continue, elective surgeries will be cancelled and waiting lists will get longer.

Dr Duddy rejected the argument that the health budget was now the largest in the history of the state and said health service demands are increasing all over the world.

“People are living longer and their health needs are more complex,” he said. “The increase in the health budget is unlikely to meet even this demographic change and has no scope to improve services. 

“Neither patients nor doctors can have much confidence that things will improve.  Let’s stop the idle chatter about how much we are spending and start concentrating on how much we need to spend.”

Announcing the plan, the Minister for Health Simon Harris said €75m will be made available to the National Treatment Purchase Fund over the next two years in an effort to drive down hospital waiting lists.

He said the €40m provided for the Winter Initiative to address overcrowding in hospital emergency departments will continue in 2017.

“I am very conscious of the people who are on trolleys in our hospitals today, especially older people, and of the pressures and stress on staff working in this environment,” he said.

“We have to continue our focused efforts to address the specific problems that arise in winter but we also have to tackle the bigger issues like staffing both in the long term and with immediate, practical measures now. 

Yesterday, emergency departments struggled to cope with one of the worst days of overcrowding this winter as 541 patients waited for a bed. 

The shocking numbers came despite a pledge in the Government's Winter Initiative plan to have no more than 236 patients on trolleys around the country on any given morning.

Minister for Health Simon Harris TD at the publication of the HSE 2017 National Service Plan. Image: RollingNews

Minister Harris said the country is facing “somewhat of a perfect storm” with the expanding population using up most of the extra money available:

“We have the highest birth rate in the European Union while at the same time having an aging population,” he said.

“Each of those people deserve to have a health service that can respond to their needs particularly our older people and our more vulnerable people and that is where there has been a huge focus.”

The Emergency Department figures for today saw very little improvement - with 536 patients still waiting in wards or on trolleys around the country.

The Irish Nurses and Midwives Organisation (INMO) said a lack of staff has seen the closure of 180 beds in acute hospitals that could have been used to alleviate the problem.

The organisation said there are currently 140 staff nurse vacancies in Emergency Departments across the country due to the inability of the HSE to recruit new staff.

Responding to the releases of the plan, the Irish Hospital Consultants Association (IHCA) criticised what they called, “the inadequate increase in the acute hospital and mental health services budgets.”

IHCA president, Dr Tom Ryan said the association is concerned the budget “will fail to address the growing waiting lists and increased patient demand for healthcare due to demographic and other reasons.” 

 “A 2.8% increase in the acute hospital budget is inadequate and completely insufficient to cater for existing patient demand,” he said.

“The plan fails to address the critical capacity constraints that have arisen from years of cuts in health sector capital expenditure.”