Thousands of hospital patients will not be treated within the Government’s official maximum waiting times next year, confidential new health service spending plans reveal.
The HSE’s service plan for next year, to be considered by Ministers today, warns of a shortfall of € 100 million in the funding for hospitals in 2016.
This may have to be addressed by reducing services in hospitals to match the funding available, the plan says, although this would be a last resort.
The 173-page HSE service plan – the agreement with the Government on how its € 13 billion budget will be spent next year – warns of a significant challenge in maintaining existing levels of service in primary care, given the funding available. It forecasts 125,000 fewer people will have medical cards next year.
The plan provides for the extension of free GP care to under-12s, extra staffing for maternity units and an extra € 10 million for cancer services. Money is also being provided to improve ambulance service response times and day-centre places for 1,500 young adults with a disability.
The plan says the primary care budget has been framed by a series of working assumptions developed with the Department of Health. If there is any variation from these assumptions it may have to go back to Government next year to seek approval for "policy changes" so that funding levels are not exceeded.
Review
The level of home help supports and homecare packages is to be maintained at current levels next year.
However, the plan says given demographic changes and the need to maximise the value of available resources, the existing model will be reviewed.
“This may necessitate maintaining waiting lists for both home help and homecare packages.”
Cabinet's consideration of the health plan today comes as Labour prepares to propose splitting the Department of Health in two. Under the reform one Cabinet minister would be given responsibility for primary and social care, as well as mental health. The new minister would also take responsibility for the roll-out of free GP care.
Obstacles
A second Cabinet minister would take responsibility for the acute hospital system, and continue reform in that sector. “The delivery of a free primary care service for all citizens will continue to hit obstacles so long as it is tethered to the acute hospital system,” a party source said. “The separation of the Department of Health would ensure that the delivery of a comprehensive primary care system would be fire-walled from the funding demands of the hospital system.”
The four-week target for processing applications for the Fair Deal nursing home scheme may not be achieved if the average number of people covered by the scheme climbs above 23,450, the HSE service plan for 2016 warns.
The current target is that no child should have to wait longer than 20 weeks for an elective procedure in hospital. The plan reveals there was only 55 per cent compliance in relation to this benchmark in 2015 and it will not be met either next year, when it forecasts only 60 per cent compliance.
Minister for Health Leo Varadkar’s promise that no adult would be waiting longer than 15 months for hospital treatment by the end of 2015 has also been missed, according to the plan. There was 90 per cent compliance for inpatients this year and projected compliance next year is 95 per cent.