Health services may be cut in some areas under new plan

The Health Service Executive’s proposed new health service plan for next year would see services reduced in some areas, despite the provision of a record €17 billion in funding in Budget 2019.

It is understood there would be fewer elective patients treated in public hospitals next year than in 2018 under the HSE proposals, which were given to Minister for Health Simon Harris in recent days. The plan is expected to be considered by the Cabinet on Tuesday,

Sources also suggested that patients seeking nursing-home care under the Fair Deal scheme may face longer waiting times next year to access the programme.

The scale of additional recruitment to the health service next year is also expected to be pared back under the draft plan, which has not yet been approved by Mr Harris.

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While sources suggested about 2,000 additional personnel will be employed, this would be significantly down on the 4,000 taken on in 2018 – a rate of recruitment that the Department of Public Expenditure had considered to be unsustainable.

Negotiations

In the budget in October, the Government provided an additional €1.05 billion in funding for the health service, bringing the total to €17 billion, the highest level ever in the history of the State.

However, the amount of money allocated is still less than the level originally sought by the HSE and it is understood the negotiations between the health authority and the Department of Health on the plan over recent weeks have been fraught.

The Irish Times understands the HSE has told Mr Harris that despite the largest-ever budget being provided, it had faced a significant challenge in producing a plan that was financially balanced while at the same time seeking to respond to growing demands .

The proposed HSE plan also originally included reductions in emergency residential places for people with disabilities. It is understood Minister of State for Disabilities Finian McGrath has objected strongly to the suggestion.

Sources said the HSE had sought funding of just over €999 million for the Fair Deal nursing home scheme in 2019, a rise of about €32 million.

Informed sources suggested that under the proposed service plan, the four-week waiting time set by the Government for accessing the scheme could actually increase next year.

Anticipate

In its instructions to the HSE for drawing up the plan, the Department of Health argued that health service activity should be planned in such a way as to anticipate and manage critical demand pressures – particularly in hospital emergency units in the initial and latter parts of the year.

Sources said, however, that the draft plan would see fewer elective or non-urgent patients treated in public hospitals next year.

The plan also includes proposals to generate savings in areas such as postage, printing, legal services, consultancy and energy.

Talks on the proposals are expected to continue on Monday.

If approved, the HSE service plan would be brought by Mr Harris to Cabinet on Tuesday and published shortly afterwards.