Press Release

Statement by Minister for Health and Children , Mary Harney T.D. on her approval of the HSE National Service Plan 2011

The Minister for Health and Children Mary Harney, T.D. today (Wednesday 22 December) announced her approval of the HSE National Service Plan 2011.

The Plan outlines how the HSE plans to deliver health and personal social services within its 2011 current budget of €13.456bn. The Service Plan is based on service activity levels for 2011 which are broadly in line with 2010 levels.

The Plan also reflects the Minister’s guidance to the HSE that there should be a particular focus on protecting services to vulnerable groups. The Minister requested the HSE to give favourable treatment to disability and mental health services in the budget setting process.

The Minister has also sought the appointment by the HSE early next year of a Clinical Lead for Paediatric Services, to work on the development of the New National Paediatric Hospital and drive the implementation of the National Integrated Paediatric Model of Care.

The Minister said “The lower saving target for disabilities and mental health will ensure an approach to priority services such as respite care which guarantees service availability and responsiveness to the needs of clients and families.

“In relation to acute hospital services, the focus for 2011 will continue to be on delivering a shift to care on a day case basis, where appropriate, and on key performance improvements in areas such as same day of surgery admission and minimising length of stay. There will be a continued and concentrated focus on reducing variances across different hospitals for similar treatments.

“I am pleased that service activity will remain at similar levels to last year and I acknowledge the emphasis on improving patient experience and patient outcomes through, amongst other initiatives, the implementation of the Acute Medicine Programme; the Emergency Medicine Programme and the Elective Surgery Programme, all of which will assist in the achievement of the targets proposed.”

Building on the report of the Expert Group on Resource Allocation, the Minister has agreed that the Executive will develop pilot arrangements in conjunction with the National Treatment Purchase Fund for the prospective activity-based funding of certain elective orthopaedic procedures and a more innovative approach to respite services for people with disabilities.

The Minister said “The objectives of the orthopaedic initiative would include more patient treatments and reductions in waiting times, together with reduction of the average cost of treatments. Clinical guidelines/protocols will be used to support efficient care and the achievement of good patient outcomes. I have asked the HSE to undertake the necessary preparatory work with the NTPF in the first quarter, such that the pilot will commence in April 2011.”

In line with the Minister’s desire for a priority approach to be given to respite care, she has asked the Executive to ensure that all Service Level Agreements with Disability Service Providers specifically identify the resources allocated to Respite Care in 2010 so that the allocation for 2011 is not less than that allocated in 2010. In addition, the NTPF in conjunction with the HSE, will undertake a study in two pilot areas, Galway and Limerick, to assess the relative cost effectiveness of different approaches to the provision of respite care by both statutory and voluntary providers.

Finally, the HSE will also examine the potential for more innovative alternative models of respite delivery, that reflect the changing needs of both clients and providers. The needs and preferences of clients will be to the fore in assessing the most suitable approaches to respite care.

Innovation Funding of €33m is available in 2011. The Minister is anxious to see a balance in the allocation of this funding between acute and primary health care, in drawing on clinical care programmes, social care programmes and other areas.

With regard to clinical programmes (including paediatrics and mental health), the Minister has advised the HSE that she wants to see the strong involvement in the allocation and use of this money of the relevant clinical leads. In other care programmes, the relevant care group lead should have strong input, including the new National Director of Children’s Services.

The Minister said: “We are asking the health service to deliver at least the same level of services next year with less staff and less money. This requires improvements in care pathways and also more flexible work practices in line with the Croke Park Agreement. It is a challenge to everyone working in the health services to focus on delivering the innovation and change required to protect and indeed improve our services for patients.”

Under the provisions of the Health Act 2004, the Minister has made arrangements for the approved Plan to be laid before both Houses of the Oireachtas and the HSE will also publish the Plan on its website.


In order to underscore the emphasis on priority services the following additional allocations totalling €56m have been made in the following areas:

  • Older People – €14m (Fair Deal – €6m; Home Care Packages – €8m)
  • Cancer – €10m
  • Childcare/Ryan Report Implementation – €9m
  • Disability – €10m
  • Suicide – €1m
  • Long Stay repayments – €12m

Further service levels outlined in the Plan include:

Primary Care

  • 527 primary care teams;
  • 18,000 patients receiving orthodontic treatment;
  • 1m dental treatments;
  • 968,000 GP out of hours contacts;
  • 1.8m persons covered by medical cards.

Children and Families

  • 5,985 children supported in care.

Older People

  • 11.98m home help hours benefiting 54,000 people;
  • 10,230 persons in receipt of home care packages.

Disability Services

  • 8,350 persons with intellectual disability and/or autism benefiting from residential services;
  • 894 persons with a physical and/or sensory disability benefiting from residential services.

Mental Health

  • Supporting 14,900 adult admissions to acute inpatient units for mental health;
  • 7,500 new child/adolescent cases offered first appointment and seen.

Acute Hospitals

  • 574,400 inpatient discharges;
  • 755,100 day cases;
  • 3.6m outpatient attendances.

Emergency Departments

  • 100% of patients admitted or discharged within 6 hours of emergency department registration;
  • 1.2m emergency presentations;
  • 361,400 emergency admissions.

Cancer Control

  • 13,000 urgent attendances and 26,000 non urgent attendances for breast cancer;
  • 100% of patients requiring urgent colonoscopy receiving access within 4 weeks.

Other Services

  • 3,580 persons receiving palliative care;
  • 9,000 clients receiving methadone treatment.