The 2016 HSE service plan carries a "substantial financial risk" arising from a €100 million shortfall in funding, the organisation's director general Tony O'Brien has said.
Speaking at the launch of the plan, Mr O’Brien said the HSE preferred to “manage” this financial challenge rather than seek to reduce services as this was not in the interests of patients and would damage staff morale.
An additional €100 million is available for new development this year and this will allow “some targeted improvements” to take place.
“The next year will be about striking a balance between the financial challenges we face while providing an increased focus on quality, safety, access and reform.”
The plan as published today has been amended to provide for a projected reduction of 50,000 medical cards next year, rather than the 125,000 originally envisaged.
This change was ordered by Cabinet when approving the plan because of fears among ministers it would create an election storm about medical card cuts.
Mr O’Brien stressed there were no plans to change the eligibility rules for medical cards in any way.
The switch to the lower forecast of 50,000 fewer cards would be funded by diverting €32 million that was allocated to the State Claims Agency but would not be needed because of the introduction of period payments of medical negligence settlements next year.
The 50,000 figure was “not a target, simply an assumption,” he said.
The extra money available next year will be spent on mental health (€35m), acute hospitals (€13m), cancer services (€10m) and disability (€7.25m).
The extension of free GP care to under-12s will cost a projected €13.5 million, though this is subject to a deal being struck with the Irish Medical Organisation.
Among previously unreported initiatives in the plan are the development of new clinical programmes for ADHD and dual diagnosis of mental illness and substance abuse; funding for stroke telemedicine and cochlear ear implants; a doubling of paediatric scoliosis operations; and training for 100 paramedics to ensure more ambulance staff work on the front line.
Additional funding of €2.5 million is being provided to add rotavirus and meningococcal B vaccines to the immunisation programme given to all schoolchildren, subject to the outcome of price negotiations with the manufacturers.”
Mr O’Brien warned health managers present at the launch that the supplementary funding provided to “rescue” the HSE in the past would not be available next year because off new fiscal rules.
“In 2016, the money spent is the money provided, not the money we wish was provided for our individual budgets.”
Mr Varadkar said real progress was being made in the health service in recent months. Trolley numbers were down up to 20 per cent on the same time last year, there were 10,000 fewer people on waiting lists in November and 4,000 additional staff were appointed this year.
At least 80 per cent of what the health service did worked well and the HSE was too often “beaten up” for getting projections wrong, he said.
Projections were just projections and it wasn’t possible to be right all the time.
Minister of State Kathleen Lynch said her priority in mental health was the provision of services in the community for those with mild to moderate mental health needs.
“We have already started working on the provision of these services in Dublin, Limerick, Cork and Wexford and hope to address deficits in other parts of the country in the weeks and months ahead. I have also asked for a particular focus to be placed on perinatal mental health.”
