The Minister for Health, Dr. James Reilly, T.D., today (Monday, 16 January, 2012) welcomed the publication of the HSE Service Plan 2012, following his approval of the Plan last Friday.
The Service Plan sets out the health and personal social services that will be delivered by the HSE within its current budget of €13.317bn. The total quantifiable cost reduction target in 2012 is €750m.
The Service Plan, which has been drawn up against the backdrop of significant funding challenges, is designed to reflect the changed priorities of the new Government and the significant programme of reform to be undertaken. It takes account of the Programme for Government commitments for health and the savings targets set out in the Comprehensive Expenditure Report 2012-2014.
The scale of the financial challenge facing the HSE means that there will be an inevitable and unavoidable reduction in services but it will not be a "straight line reduction". The Service Plan commits the HSE to minimising the impact on services by fast tracking new, innovative and more efficient ways of using reduced resources. It reflects the need to move to new models of care across all service areas which, as Dr. Reilly has stressed, must treat patients at the lowest level of complexity and provide quality services at the least possible cost. It also includes a commitment to addressing staffing levels, skill mix and staff attendance patterns/rosters within the context of the Public Service Agreement. The Plan will be implemented in the context of the significant new governance structures for the health services recently announced by the Minister.
The Minister said:"The need for radical change in our health services has been apparent since the Celtic Tiger days of excess. The new financial reality in which the health system is operating means that there is a greater need than ever before to drive that change, innovate and implement efficiencies. Continuing with the status quo was not an option in the time of plenty. Dispensing with the status quo is now in straitened times essential. This Plan outlines how the system will adapt in order to minimise reductions in service levels while facing up to financial and reform challenges".
The Minister wishes to see a much greater level of integration of services to ensure that existing resources are applied to best meet the needs of older people. The HSE will progress proposals with the Department as a matter of urgency to protect the viability of as many public community nursing units as possible within available funding and staffing resources and to increase intermediate care capacity by reallocating funding from long-term residential care and potential other sources such as acute hospitals."I welcome the many reform initiatives in the Plan, such as the development of proposals to protect the viability of community nursing units and to increase intermediate/community care capacity; a significant strengthening of primary care services; the enhancement of community mental health teams; a more tailored approach to disability services; establishment of the new Children and Family Support Agency; progression of the clinical care programmes and plans to commence roll out of the colorectal cancer screening programme."
"The level of service reduction will be less than the level of budget reduction as a result of efficiencies that will be delivered across all care group areas. For instance, while acute hospitals face an expenditure reduction of 7.8%, the further roll-out of the clinical care programmes and other measures to improve the efficiency of clinical care delivery will limit the reduction in patient activity to an average 3% against 2011 outturn. Hospitals will work closely with the Special Delivery Unit to ensure that, notwithstanding this reduction, nobody waits longer than 9 months for an elective procedure, thus ensuring equitable access for all.""The HSE will also adopt a new approach to tackling the unacceptable level of hospital income that is currently uncollected. Demanding targets have been set in this regard."
The number employed in the health service will fall during 2012. The end 2012 employment ceiling is about 102,100- a reduction of 3,200 compared to the 2011 target. The Minister intends to review the Plan when the full impact of the staff leaving at the end of the 29 February "grace period" is known.
The Minister said "The cumulative impact of staff reductions from this year and previous years, further increases the need for greater flexibilities in work practices and rosters as well as redeployment. Successful implementation of the Public Service Agreement will be crucial in bringing about these changes".
During 2012, improved patient outcome measures will be developed to support better performance management of the health service, including quality and access to emergency and scheduled care, outpatients and diagnostics; implementation of the clinical care programmes; and outcomes for people with disabilities and for people who may be socially excluded.
In approving the Plan, the Minister asked the HSE Board to pay particular attention to the issues of (i) early implementation of the various reforms identified in the Plan and pro-active risk management, (ii) increased financial transparency and control and (iii) employment control.
The Minister concluded: "It is imperative that a strong budgetary focus is put in place at all levels within the health service from the outset of this year. Prompt intervention will be required by budget holders to correct any emerging issues. Notwithstanding the need for adherence to budgets, it is imperative that HSE managers deliver quality services to patients in line with the performance indicators outlined in the Plan."