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Budget 2021: €4 billion to protect, reform and expand health and social care services and implement universal healthcare

Budget 2021: €4 billion to protect, reform and expand health and social care services and implement universal healthcare

• €467 million to permanently fund 2,600 beds in acute and community settings, including €52m for critical care beds
• €100 million for people with a disability
• €38m for new mental health services
• €1.7 billion to protect health care workers, vulnerable groups and public from the impacts of COVID-19
• €425 million to deliver enhanced community and social care services including an additional 5 million home care hours
• €318 million to improve access to care including a new Access to Care fund
• €147 million to reform the way care is delivered through the accelerated implementation of national strategies
• €50m for new drugs
• €20m for Healthy Ireland
• An increase of approximately 16,000 posts in the health workforce

Minister for Health Stephen Donnelly TD said today (Wednesday)

Budget 2021 saw an extra €4 billion added to the health budget, the largest budget increase in the history of the state. This money signals how determined we in government are to fund an expansion of, and improvements in, our health and social care services.

Budget 2021 provides for the continuation of the extraordinary public health measures and health and social care service supports and capacity introduced in 2020, measures that are essential to protect health care workers, vulnerable groups and the wider public from the worst impacts of COVID-19. But this Budget will not just be about the response to COVID-19, it is also about building positive permanent change into our health service. It provides the resources we need, and that our health care professionals and service users have asked for, to grow capacity, and deliver universal healthcare across our health service.

While the pandemic highlighted major challenges in our health service, it has also highlighted the many strengths within the service. In Budget 2021 my objective is to address these challenges head on and to build upon the strengths. The investments being made today will mean that when this pandemic ends, Ireland will have a better, more resilient healthcare system – one which has the capacity required to meet the changing needs of the population, and one which has permanently embedded reform.

This Budget will deliver funding for 2,600 beds and about 16,000 staff for our health service over Budget 2020 levels. It will provide permanent funding for the capacity and staff introduced in 2020 and planned under the HSE Winter Plan. It will move care from hospitals to communities, closer to home. It will ensure that more people have access to primary care and that more older people will have medical cards. It will ensure that funding is in place for new medicines and technologies. It is providing unprecedented funding for key national strategies that will improve maternity and gynaecology services, cancer services, our trauma network, palliative care, dementia services and women’s health.

The Minister said:

Hundreds of thousands of people were on waiting lists before COVID-19 hit. Since the beginning of the pandemic this has worsened as much elective, or planned, care paused earlier this year. The impact of this pandemic on levels of unmet need is difficult to quantify, but it is a huge concern for me as Health Minister. Therefore, I have established an Access to Care Fund of €210 million and will be allocating a budget of €130 million to the National Treatment Purchase Fund (NTPF). It will empower our GPs and provide access to more than 130,000 additional diagnostic tests.

Minister of State with responsibility for Mental Health and Older People Mary Butler said

I am delighted today to announce that more than €1 billion has been allocated to mental health in Budget 2021. This is an increase of €50 million on last year’s budget and comprises €38 million for new measures, including the continuation of COVID-19 supports, and €12 million to meet existing needs.

Of the €38 million, a significant sum of €23 million will be allocated to commence implementation of “Sharing the Vision – A Mental Health Policy for Everyone”, including enhancement of mental health community teams, child and adolescent mental health services, crisis resolution services, development of clinical care programmes and investment in peer support workers and employment supports.

COVID-19 has been source of significant stress, anxiety, worry and fear for many people and so it’s important that funding will also address ongoing mental health needs arising from the impact of the pandemic.

That’s why €15 million will be dedicated to reinforcing our response to the additional mental health challenges posed by COVID-19. As part of this response, investment will be made in step down beds in the community, e-mental health supports, supporting the NGO sector in providing critical mental health services, in addition to capital works.

For our older people and those living in residential care, this has been a particularly difficult time. The very significant additional funding in Budget 2021, including 5 million additional home care hours, over National Service Plan 2020 levels, recognises those difficulties and is aimed at keeping older people healthy and happy, in their community, for as long as possible. I am also very pleased to announce that €12.9 million of the additional funding allocated to older persons in Budget 2021 will be dedicated to enhancing dementia focussed services and supports. The integrated model of community care being proposed under Budget 2021 is a key part of implementing Sláintecare and delivers on Government’s commitment to implementing the recommendations of the Nursing Homes Expert Panel.

Minister of State with Responsibility for Public Health, Wellbeing and the National Drugs Strategy Frank Feighan TD said

Today I am announcing funding of €20 million for Healthy Ireland, a vital Sláintecare initiative that empowers people to take responsibility for their own health and supports individuals and communities to live healthier lives, including funding for our national obesity strategy, healthy eating policies, and smoking cessation and alcohol reduction programmes.

I am also confirming a €12 million investment in our hugely important public health workforce, who have done such vital work during the pandemic.”

I am announcing €10 million in additional funding to expand the availability of drug and alcohol services across the country, including community-based services and residential treatment programmes. The funding will also provide health supports for over 2,000 people who are homeless with complex health needs, and increase access to health services for Roma, Travellers, asylum seekers and other vulnerable groups.

I have also secured €4.2 million to continue to support the additional 700 people who were put on opioid substitution treatment as a contingency measure during COVID-19. This funding delivers on key commitments in the Programme for Government.

Minister of State with responsibility for Disability Anne Rabbitte TD said

Today’s investment of €100m in disability services is unprecedented.

The increased level of funding will deliver more timely intervention for children and young people by providing 100 additional posts for children’s therapeutic services.

The additional investment will build the capacity of our adult disability services and increase day services by one day a week, for those whose services were reduced due to COVID-19. It will also support around 1,700 young people who leave school and training programmes in 2021.

New residential places will be provided for persons with a disability, while the provision of intensive support packages will support persons with complex needs to enable them to remain in their own community. There will also be a renewed focus on assisting people to move out of congregated settings to homes in the community and addressing the inappropriate placement of young people with disabilities in nursing homes.

Increased community support will help to keep people living in their own homes through increased and alternative models of respite, intensive support packages, and additional PA hours.

I am also very pleased to announce that €20 million is being made available on a once off basis in the current year to support voluntary disability service providers engaged in the Transforming Lives Reform programme. Criteria for disbursement of this funding will be available next week.

Minister Donnelly said the Budget would also provide for;

• A HSE/National Treatment Fund action plan for 2021 to address the impact of COVID-19 on access to scheduled care
• Greater resilience in cancer services in the context of COVID-19 to minimise delays to diagnosis and to protect against future COVID-19 outbreaks
• €58m for eHealth and ICT infrastructure as key drivers of the effective and efficient flow of health information
• Implementation of key national strategies such as National Cancer Strategy 2017-2026; National Maternity Strategy 2016 -2026; A Trauma System for Ireland; the National Ambulance Service Strategic Plan; Paediatric services including new children’s hospital; Organ Donation and Transplant Services; The Women’s Health Taskforce; Taskforce on Staffing and Skill Mix for Nursing; Sláintecare Contract; Public Health Workforce; National Positive Ageing Strategy; Housing Options for our Ageing Population; National Dementia Strategy; National Carers Strategy; Palliative Care Strategy; COVID-19 Nursing Homes Expert Panel.

Notes to the Editor

All funding, output and activity levels incorporated in Budget 2021 are benchmarked against Budget 2020 levels. It incorporates the HSE Winter Plan and provides permanent funding for the extra capacity and additional staff introduced and planned for 2020 and Q1 2021.

At the start of 2020 these was 10,733 acute inpatient beds open (excluding Critical Care Beds n=255]. In Budget 2021 we are committing funding to allow the HSE to open and staff an additional 1,146 inpatient beds by end 2021. Taken together this will result in 11,879 inpatient beds open at end 2021. However, the total number of inpatient beds will fluctuate significantly as a result of social distancing and infection prevention and control measures. The capacity review targeted an increase to 11,900 inpatient beds by the end 2021.
Of the 1,146 additional beds, the HSE advise that by end 2020 approximately 650 additional beds are scheduled to be open, a further approximately 280 are planned in the first 4 months of 2021 with 216 planned by end 2021. The actual number of new beds that come on line in the time periods referenced may vary for operational reasons and funding is provided for the full 1,146 beds in 2021.
In relation to critical care bed there was 255 beds open at start of 2020. In Budget 2021 funding for an additional 66 beds has been provided. This will result in 321 critical care beds. The capacity review targeted an increase to 330 critical care beds by the end 2021.
Of the additional 66 critical care beds, the HSE advise that by end 2020 approximately 37 beds are scheduled to be open, 5 in Q1 2021 with the remaining 24 planned by the end of 2021. The actual number of new beds that come on line in the time periods referenced may vary for operational reasons and funding is provided for the full 66 additional beds in 2021.

The NSP will set out the up to date position at that time.