Opening Statement by Minister for Health Simon Harris TD at the Joint Committee on Health

**Check Against Delivery**


Chairman, Committee Members

I am very pleased to have this opportunity to appear before you once again today.

I will make a brief opening statement and then take questions from the Committee Members.

Firstly today I want to thank all health service staff who worked yesterday during what was a very difficult and challenging day for health services. It is at times like this we see how our staff go above and beyond to deliver essential services.

The decision to cancel appointments was not taken lightly, but done in the interest of public and patient safety. I know that the HSE is working to reschedule cancelled appointments as quickly as possible. We do expect some continued disruption over the coming days, people may experience some delays in their appointments and discharges from hospitals but we are working, as a priority, for a return to normal service though this may take some time.


Budget 2018   

Last week my colleague, the Minister for Finance, announced that the total Health Budget for 2018 will be almost €15.3 billion. An additional €646 million for current expenditure has been allocated, compared with this year’s budget, of which over €200 million is for new developments.

There is also an additional €471 million for capital spending over the period 2018 to 2021, with a €39m allocation for capital in 2018.

A further €40 million access fund will be provided in 2017 to prepare for additional elective procedures and to support our Emergency Departments over the coming period.

Budget 2018 will mean additional frontline staff for the health service, across the acute, mental health, disability, primary and community care sectors. This will give better access to health services, more help for families and provide additional supports for disability, mental health and old and vulnerable people.

Funding is being targeted in a number of key areas, including the following:

  •    New access programme for 2017/2018
  •    Helping families with the cost of medication and care
  •    Shift to Primary Care
  •    Expanding and developing Mental Health Services
  •    Supporting Disability Services·
  •    Supporting the most vulnerable


New access programme for 2017/2018

Reducing waiting times for patients and improving access to our health services is one of my key priorities. Budget 2018 will increase investment in the NTPF from its original allocation of €20m in 2017 to €55m in 2018. This significant increase in funding will mean that over 18,000 additional procedures will be offered to patients next year across a range of specialties and procedures and in both private and public hospitals. Additional funding of €10m will be provided in 2017 to fund further NTPF initiatives and HSE insourcing initiatives in order to continue the strong focus on reducing waiting times for hospital procedures this year. This will ensure that more patients are seen in our hospitals and fewer patients have to bear the burden of long waiting times. Funding for the reduction in waiting times for paediatric orthopedic services and treatments for scoliosis is also being provided, building on progress which is underway.

In addition, funding to improve access to emergency care in 2018 will enable the opening of additional hospital capacity, including new beds and by providing additional diagnostic services and surge capacity to reduce ED overcrowding. Additional capacity will be introduced in Galway, Our Lady of Lourdes Drogheda, Beaumont, Roscommon and South Tipperary.

Additional funding has been made available to progress key strategic initiatives. This will enable progress in the phased implementation of the National Cancer Strategy, the National Maternity Strategy, and in the continued development of the National Ambulance Service, leading to sustainable improvement in these services. The new children’s hospital project continues to be a key priority for this year, as we continue the transformation change programme currently underway.


Helping families with the cost of medication and care

Reducing the cost of medicines for families is a key commitment in the Programme for Government and, building on the progress in 2017 where I reduced the prescription charge for over 70’s, I am delighted to be in a position in Budget 2018 to reduce the cost of medicines for families from 1 January 2018. In line with the recommendations of the Report of the Oireachtas Committee on the Future of Healthcare, and subject to available resources, it is my intention to build upon these initiatives in future years and continue to reduce the cost of medicines for families.


Shift to Primary Care

The development of primary care is central to the Government’s objective to deliver a high-quality, integrated and cost-effective health care system. The Report of the Oireachtas Committee on the Future of Healthcare also provided strong support for the need to strengthen our services as part of the overall reform of our health services.

The provision of a €25 million primary care fund in Budget 2018 demonstrates this Government’s ongoing commitment to shifting the model of healthcare towards a more comprehensive and accessible primary care service in order to deliver better care close to home in communities across the country.  This new funding will enable a range of initiatives to be progressed in 2018 which will focus on disease prevention and early intervention, particularly through the further development and expansion of GP services, our Community Intervention Teams and the recruitment of additional therapy posts.  Throughout 2018 there will also be a continued focus on the development of primary care centres and primary care teams.

In relation to GP care I am optimistic that agreement can be reached with GP representatives in the coming months on significant service developments that can also be introduced during 2018. As outlined by the Minister for Public Expenditure and reform in his budget speech this will be the start of a multi-annual change process that will enhance the role of primary care as the foundation of a more accessible and effective health service.


Expanding and developing Mental Health Services

The provision of an additional €35 million for 2018 will help us to build on the work commenced in 2017 on the enhancement of Community Teams for Children, Adults, Later Life and Mental Health Intellectual Disability services. It will also help us to continue our move towards a full 24/7 service with an initial focus on increasing the provision of services on a 7-day-a-week basis. Further improvements are also planned to services for Eating Disorders and Dual Diagnosis. It is important, however, that we use this extra funding to ensure that not only are our services of a high quality but that we provide as seamless as possible a service for every service-user. I have asked the HSE to prioritise this in 2018.

I have also committed to providing a further €55 million in additional funding in 2019. This will allow for a multi-annual approach to developing our mental health services taking account of the Review of Vision for Change which is underway.  It will see total additional funding provided for the implementation of A Vision for Change rise to €105 million over the period 2017-2019.


Supporting Disability Services

I am very pleased that we have been able to both build upon significant existing resources and obtain additional funding for disability services.  Minister of State McGrath has also secured supports for people with disabilities within the other key budgetary departments in his portfolio, Social Protection and Justice as well as the Department of Education. On taking office, one of Minister McGrath’s priorities was to ensure that all young adults leaving school or rehabilitative training would have access to supports and services which meet their needs at one of the most crucial transition points of their lives. I can confirm that the additional funding obtained this year will provide for the full year effect of these additional services in 2017, as well as making sure that the needs of all those leaving school in 2018 will also be addressed.


Supporting the most vulnerable

The Government is committed to making significant progress in implementing the actions identified as a priority for 2018 in the new strategy to respond to drug and alcohol use in Ireland “Reducing Harm, Supporting Recovery”. The Government also intends to maintain a focus on the health needs of the most vulnerable groups in society, who can experience health inequalities, have difficulties accessing services and present with multiple, complex health and support needs. In this context, I am pleased to announce that significant additional funding has been approved to address the health needs of people who are homeless and have mental health and addiction issues in line with Rebuilding Ireland.

We are committed to the Healthy Ireland Fund and that another €5 million will be available in 2018. The Fund will support partnership working in different sectors and communities to help ensure our policies under Healthy Ireland have an impact at local level. It’s important that we keep a focus on prevention and on empowering people and communities to improve their own health and wellbeing.


Sláintecare Report

I am conscious that I will appear before this committee next month on the Slaintecare report so I won’t dwell too long on it this morning except to say I see the report as a solid framework to move forward. What we have to do now is build around it a process of planning and implementation, that will start to translate the vision into concrete change, and the change into reality. This process is already underway and earlier in my statement I referenced some areas where money from Budget 2018 will be used to implement some of the Sláintecare recommendations. The Government has given its approval to move ahead with the establishment of a Sláintecare Programme Office.

In the meantime, work is underway in my Department to prepare a Sláintecare implementation plan. Last Friday I updated my Cabinet colleagues on progress to date and the next steps to be taken and I will report back to Government again in December.

On foot of these discussions I signalled my intention to proceed immediately on certain SlainteCare recommendations including the impact assessment of the removal of private activity from public hospitals, the alignment of community and hospital structures and the introduction of an independent Board to oversee HSE performance.

That concludes my opening statement, myself and my colleague will now take whatever questions the members have.