Opening Statement by Minister for Health Leo Varadkar to the Joint Committee on Health and Children Quarterly Meeting, Thursday 23rd October

Chairman, members of the Committee,

Thank you for the invitation to attend.  I’m joined by Minister Kathleen Lynch and officials from my Department: Jim Breslin, the Secretary General and Fergal Goodman, Assistant Secretary, Primary Care.  Here as well is Tony O’Brien, Director General of the HSE and his colleagues.

Last week, I updated the Committee on how we were dealing with the threat of Ebola.  The risk to Ireland is still considered low but we are maintaining our levels of preparedness.  We continue to plan and prepare at a national level while engaging at EU and international level to contribute and participate in planning and preparedness.

It’s just over 100 days since I was appointed Minister for Health.  On my appointment, I said my first priority was a realistic budget and I believe we achieved that in Budget 2015 with an increase in the exchequer allocation of over €300 million when compared to the 2014 allocation.

Alongside an increase in allocation, we have identified once-off additional income measures of some €330 million and procurement, medicine and agency staff savings of some €130 million.  Combined, this means that the HSE has over €750 million more to fund services than it did at the time it prepared the 2014 Service Plan, roughly this time last year.

The cycle of cuts in health has come to an end. As I said on the night of the Budget we have secured a welcome but modest increase in the total financial resources available to the HSE, the first in seven years.

The 2015 budget is challenging, but its targets are achievable. We are now entering a two year process which stabilises the budget, and allows for existing levels of service to continue, along with some enhancements.

Members of the Committee will know, as much as I do, that despite the additional spending power, next year remains a challenge.  There are still cost pressures: our rising population, and within that, more older people. Our achievements in developing new medicines and treatments come with higher bills.  We know our responsibilities in addressing these needs but we must recognise the additional resource demands that come with that.

Management of health spending within available resources will require an exceptional management focus with strict adherence by all services and budget holders to their allocations.

I think it’s important that we are clear that where we identify further savings or efficiencies, we now have the capacity and the scope to reinvest the savings back into the health service, rather than giving them up to service a debt or reduce a deficit.

The progress we have made as a country in dealing with the legacy of the global financial crisis has empowered us to take more control of our resources in the health service.  This doesn’t just apply to resources financial – we will also have more autonomy with regard to staffing and human resources, following Minister Howlin’s announcement.

With greater autonomy and capacity to reuse our savings for services, comes an even greater responsibility for cost containment and cost avoidance.

As a country, we took tough decisions in the health services, just as we did in education and a range of other public services.  Tough decisions still have to be made – in terms of managing resources, addressing performance and ensuring accountability – but the difference now is that those decisions will yield benefits that we can use to improve our health services.

For this reason, we are focusing on an improved accountability framework in 2015 so that our hard-earned flexibility won’t go to waste and that people and patients will benefit from our economic progress.  We are also continuing the reform programme because improving our structures through, for example, hospital groups, helps staff in the health services do a better job.

Better structures empower people and then they can deliver better care.  Reform isn’t an end in itself but it’s a valuable tool which helps us do more with the additional resources we now have.

Our Budget is patient-centred – we’ve frozen hospital and prescription charges and there are no adjustments to the drugs payment scheme threshold or eligibility for medical cards.  With the patient in mind, we’re going to deliver on GP care for under 6s and over 70s, once we come to an agreement with the IMO.  Once this is achieved half of the population will have access to GP services without fees.

We have also allocated specific funding to deal with delayed discharges for two reasons: delayed discharges are people who have earned the right to be treated with dignity and respect and because it improves health outcomes when discharges from hospital are timely.  We’ve also set aside further money for mental health – €35 million in 2015 – and we’re extending BreastCheck to women aged 65 to 69 years.

As part of this two year process starting in 2015, the spending ceiling for 2016 has been increased further by €174 million. This does not mean that we are awash with cash but it does make the funding situation in the health service more manageable.

I should also mention that we have received a capital allocation of €382 million.  Members of the Committee will know that there are five important capital programmes we intend to progress – the new children’s hospital, the new mental health campus at Portrane, the national maternity hospital, the development of primary care centres and community nursing homes.

We also plan to invest in ICT, where existing systems and the level of integration are not appropriate to a health service of this scale and complexity.

Better facilities and better IT systems benefit patients and their families.  They help improve health outcomes and they help our staff do a better job.  They are not just an investment in computers and software but an investment in our staff, our people and our shared future.

The next step in the process is for the HSE to produce a Service Plan which will set out the volume and type of health services to be provided in 2015 within the agreed allocation.

With the return of the Vote to the Department for 2015, working closely with our colleagues in the HSE, the Department will have be able to better monitor budgets and spending.  This is part of the improved accountability framework I mentioned earlier.  Once the service planning process has been concluded, the HSE will publish it and we’ll immediately set to work on ensuring it is fully implemented.

I know Tony has an opening statement and he will be addressing some specific issues the Committee wishes to hear about so I will conclude there, in order that we can deal with those issues and the questions the Committee has.

Thank you.