Lots more cash for health, but any new ideas on which to spend it?

The money continues to roll into health on foot of Budget 2022, with an additional €1 billion in funding announced on Tuesday to go with a similar amount provided last year.

But after weeks of damaging controversy over the Sláintecare plan for service reform, the real question is whether there are any new ideas to go with all of this extra cash.

You only have to look at the latest trolley figures from the Irish Nurses and Midwives Organisation to get an indication of the mountain there is to climb when it comes to improving access to the health service.

A total of 506 sick patients were left waiting for a bed on Tuesday, the highest daily total since the Covid-19 pandemic struck Ireland in March of last year. The worst affected hospital was Limerick, where 91 patients were waiting for admission, as staff battled a Covid-19 outbreak.

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We have little enough to show for all the extra money pumped into health of late. Waiting lists are set to hit the 1 million mark by Christmas and the thornier issues around Sláintecare, such as the public-only consultant contract, have yet to be worked out.

Covid-19, of course, is one reason why the reform plans for the health service are behind schedule. The pandemic, and the cyberattack on the Health Service Executive’s IT systems in mid-May, further forced up waiting lists and slowed down recruitment drives.

As a result, there is an underspend in health of more than €800 million – a striking contrast to the years of massive overspending that became a recurrent stain on the sector for many years before the pandemic.

As Government documents indicate, 2,500 additional beds were promised across critical care, acute hospitals, sub-acute and community settings this year, of which 2,200 have been delivered.

No one will complain if the rest come next year but recruitment is certainly emerging as a problem area across the service.

An additional €250 million is being pumped into waiting-list initiatives. Much of this will be spent in the private sector, echoing previous attempts to cut waiting lists which produced mixed results and little lasting benefit.

Reinventing the wheel

Given the challenges of Covid-19 and with the winter ahead, any progress will be hard won.

Minister for Health Stephen Donnelly has rightly chosen to support areas that are working well, such as the clinical programmes. And rather than trying to reinvent the wheel, he has opted to pump money into existing programmes that up to now had been starved of funds, such as the women's health programme.

Extending GP care to six- and seven-year-olds is in line with Government policy, but it will only work properly if people can access a family doctor locally and there is plenty of evidence that patients are waiting longer for GP appointments, while new patients are struggling to find doctors in some parts of the country.

Donnelly and his officials will reveal more of the detail behind their plans on Wednesday. Whatever they do, they need to get on with it, given the time lost to Covid-19, the changing fortunes of political life and the scale of the challenges. But at least they won’t have to plead poverty.