Martin outlines unprecedented capital development for the health services
Mr Micheál Martin TD, Minister for Health and Children today announced details of the investment being made by the Government for the health services under the National Development Plan (2000-2006).
The Minister said “the total of £2 billion recently made available by the Government represents almost a trebling of investment compared to the previous 7 year period. In real terms, the overall amount will be significantly higher as I expect that the £2 billion will be subject to inflation increases over the life of the Plan. It is not possible to say at this stage what the final outturn figure will be as the annual inflator rates will only be known each year depending on prevailing economic circumstances. However, the overall picture is indeed most positive. The serious approach adopted by this Government to health capital funding is highlighted by the fact that this is the first time that a National Development Plan has included the health services to any significant extent.
I have ensured that the NDP will bring positive benefits to all sections of our health services. The £2 billion starting out point will enable substantial improvements in the physical infrastructure and equipping of acute hospitals, and in facilities for the intellectually and physically disabled, older persons, the mentally ill and children in need of care and protection. The Plan also provides for much needed investment in the vert important area of information technology. The whole thrust of the Plan will be to create an infrastructure that will bring significant and tangible advances in delivering a more patient-centred and accessible service. Patients have a right to expect the best possible care and treatment from well trained and fully qualified health professionals in modern and appropriate surroundings. A healthy population is critical to ensuring that economic success is delivered and that the resources of the country are exploited to the fullest extent possible.
A fundamental decision taken by the Minister was that the NDP would be administered nationally on a health Care Programme basis. These include areas relating to General Hospitals, Community Health, Disability Services, etc. This will ensure meaningful progress across all areas of the health service so that a wide range of serious infrastructural deficiencies are addressed. This approach will also be the most appropriate in terms of measuring outcomes and performance indicators of the NDP for the health sector.
On the question of funding arrangements, the Minister explained “in order to successfully merge the old and new systems for capital planning and funding, funding figures did not issue for 2000. Instead, the £231 million available for the current year, which is an increase of about £60 million on last year, will ensure that the existing capital commitments of boards are met. It will also allow the Government to commence a national re-equipping and refurbishment programme in key service areas.
I am today announcing an additional £72 million for equipment and refurbishment purposes in 2000. This will also cover the important areas of maintenance and fire precautions. The sum of £72 million is in addition to the £18 million already provided this year for specific areas.
Bearing in mind the specific approach agreed for this year, the funding figures that therefore issued to boards related to the years 2001-6 only. These amounts, by Care Programme nationally, are as follows:-
|Care Programme||£m (2001-6)|
|Services for Older People||188.0|
|Child Care||104 0|
|Information & Communications Technology (ICT)||56.0 (2000-2 only)|
Figures for Information Technology have issued for the years 2000-2 only at this stage given the rapidly changing needs in this area. The outstanding amounts totalling to the overall £2 billion comprises the capital needs for 2000, provision for IT from 2003 onwards and various miscellaneous expenditure that does not neatly fall into any of the above Care Programmes. It is expected that various elements of the outstanding funding not listed above will bring the overall General Hospitals amount to around £1 billion over the life of the Plan.
In regard to the Plan, the Minister stressed that “approval for the go ahead for projects shown in each board’s plan will be subject to individual approval and the normal criteria governing projects such as agreement on planning, costings, construction start-dates and the priorities of the overall Capital Programme at any particular time”.
In preparing their estimates for the NDP, health boards were asked to make provision for items that transcend health care programmes such as:-
- Replacement Equipment
- Refurbishment Works
- Fire Precautions
- Maintenance Works
- Health & Safety
- Ambulance Service
In recent times, the acute hospital sector has utilised around 70% of capital investment. The Minister is strongly committed to shifting the balance towards the non-hospital sector so that the £2 billion is split equally between the hospital and non-hospital areas under the NDP. Investment must follow clear strategies on how best to deliver services in the most cost effective way.
The NDP will, for example, enable considerable progress to be made in implementing the recommendations set out in the Report of the Waiting List Review Group, the National Cancer Strategy, the Report of the Cardiovascular Strategy Group, and the Programme for the Development of Renal Services now being progressed to varying degrees.
In relation to maximising funding with service outturns, the Minister said “my overall aim is to ensure that the expenditure targets for the hospital/non-hospital sectors are achieved at the end of the NDP. The process will be subject to continuous review in terms of services priorities, expenditure patterns and other relevant factors. In this context, it has been made clear to boards that there will be flexibility of funding to realise these objectives as fully as possible. My Department will work very closely with boards over the life of the NDP to ensure that services overall are planned and delivered in a co-ordinated and effective manner.
In conclusion, he stressed that “the NDP presents an unprecedented opportunity to develop our healthcare services infrastructure to a level that was undreamed of only a few years ago. For too long our health care professionals, and more importantly the users that ultimately fund the system, have endured poor and inadequate facilities in many areas of the country. This often hindered the development of medical and other care services to clients. This picture will now radically change over the next few years.
A number of major acute hospital projects are expected to materialise under the NDP. These include, new developments at St. Vincent’s, Elm Park, the Mater Hospital, Tullamore, UCHG, and Cork University Hospital. Equally important, a major push will target new capital at the non-hospital area which has clearly not had the required investment in the past. During the course of the seven year Plan programmes such as those for older people, the intellectually disabled or for children at-risk will have a greatly improved physical environment to ensure a high quality and client-centred service.”