HSE service plan marks progress on budgetary front but uncertainties loom on horizon

Superbug or flu outbreak brings particular threat to service costs

The publication of the 2017 national service plan by the Health Service Executive (HSE) outlines Government priorities for our beleaguered public health system in the year ahead. Will the €14 billion plan lead to an improvement in front-line services for patients?

The plan focuses on some of the "choke" points in our public health services: hospital waiting lists, emergency department overcrowding and the provision of home care and nursing home packages. While the National Treatment Purchase Fund has a proven track record in reducing waiting lists and is likely to extract good value for the €20 million it has been allocated for 2017, the same cannot be said for the existing €40 million Winter Initiative, which has already failed to stem the tide of rising trolley numbers in emergency departments.

A projected 1.8 per cent increase in the number of people who will receive home care packages in 2017 is unrealistic. Already in 2016, some patients and their families who have been approved for a package are being told by local HSE offices that funding is not available to implement the decision. How such a miserly funding increase can meet current demand, let alone satisfy patient need next year, must be explained by Minister for Health Simon Harris.

There is an honesty, at least, in the HSE warning its budget for 2017 may not be sufficient to meet competing demands, including replacing ageing medical equipment and costs of new drugs. And there are welcome preventive health and patient safety initiatives in the plan. The holding back of some of the budget by the Department of Health for allocation during 2017 is a noteworthy development.

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With no clear allocation of funding to meet back pay due to unfulfilled elements of the hospital consultant contract – the subject of a recent legal test case – there is already a significant threat to next year’s health budget. And should an unexpected global infectious diseases event occur in 2017, such as a superbug or flu outbreak, existing holes in the service plan can only deepen.