How the HSE will spend its 2017 budget
The HSE will spend €81.3 million expanding and developing services this year, writes Maureen Browne.
Of this, €20 million will go to the Primary Care Reimbursement Service, €15 million will go to mental health (as part of the plan that will be funded at €35 million for the full year), €12 million will go to primary care, €11.8 million to disability services, €10 million for services to older people, €9 million to acute hospitals, €1.5 million to social inclusion €1 million to national ambulance service and emergency management and €1 million to national services.
A total of €118.1m 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. It is provided to offset the increased cost of employing existing levels of staff and does not allow for an increase in staff numbers.
A €100m capital programme facilitating the planned “Time to Move on from Congregated Settings” will see 223 people moved to community living, with 50 additional homes purchased.
The HSE says 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,” it warns
For 2017, a total of €808.1 million has been allocated to Community Healthcare in Ireland, compared to €777.3 last year.
Of this year’s funding, €133.3 million goes to social inclusion (€129.9 in 2016), €76.5 million to palliative care (€75.6 million in 2016), €2,560.7 million to PCRS (€2,555.6 million in 2016) and €249.6 million to local demand led schemes (€246.6 million in 2016).
Primary Care will receive a total of €1,017,8 million (€982.7 million in 2016). The €36.5 million being held by the Department of Health for special initiatives will be spent on Primary Care – €18.5m for service developments including reduced prescription charges for those aged over 70.
This year Health & Wellbeing will receive €233.3 million (€223.9 million in 2016)
A total of €853.1 million goes to mental health this year (€828.6 million in 2016).There will be €15m to initiate new developments in 2017 with a recurring full year value of up to €35 million.
Social care will receive €3,394 million (€3,270.9 million in 2016). Of this), €940 million to the Nursing Home Support Scheme (NHSS), the same as last year, €765.4 million to services for older people (€738.7 million in 2016) and €1,688.6 million goes to disability services (€1,592.2 million in 2016.
Inpatient discharges are also expected to rise with 12,600 more people expected to be seen.
The HSE said that in Ireland, one in 10 adults of working age reported at least one disability. “Volume of demand across all types of services including residential and respite has increased. In excess of 36% of residential service users are aged 55 years or older. This has increased from 17% in 1996. Building on work undertaken to date the NSP 2017 continues to focus on the implementation of the reform programme Transforming Lives. Specific target areas in 2017 involve an investment of €16.2m in emergency cases to support a total of 395 individuals – 185 in new residential emergency places and 210 in new home support/in home respite for emergency cases. A total of €10m will be provided to support 1500 school leavers, while €5.5m will enhance home support services through the personal assistant programme.
“A €100m capital programme facilitating the planned “Time to Move on from Congregated Settings” will see 223 people moved to community living, with 50 additional homes purchased. An investment of €45m over three years will support this transition and innovation.”
The National Cancer Control Programme will get €78.4 million in 2017 (€71.5 million in 2016).
The National Ambulance Service and emergency management have been allocated €156.5 million for 2017 (€152.9 in 2016).
Hospital care has been allocated €4,367 million this year(€4,248.6 in 2016).
The HSE said that within the Acute Hospital Division, an additional 26,881 new presentations to ED were expected in 2017. Recognising the ongoing pressures being experienced in EDs, the HSE would continue to drive the implementation of the ED taskforce plan recommendations in 2017 with a target of 5% improvement in total time patients wait (Patient Experience Time) – aspiring to a 100% compliance level. There would be a further focus on eliminating those waiting over 24 hours before admission.
“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 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.”
The State Claims Agency is to receive €224 million this year (€198 million in 2016.
A total of €14.1 million has been allocated to overseas services, the same as last year.
Pensions will cost the HSE €565.4 million in 2017 (€502.6 million last year and the pension levy for this year will come to €156 million (€171 million in 2016).