The Health Service Executive will face an “immense challenge” to deliver the same levels of service provided in 2010 with reduced funding of some €683 million this year, it said today.
Publishing the HSE's national service plan for 2011, chief executive Cathal Magee said the gross reduction in funding was €962 million, which was offset by the return of €279 for additional expenditure relating primarily to medical cards, new services, pensions costs and the clinical indemnity scheme.
The plan sets out the type and volume of service the executive will provide directly and through a range of funded agencies during next year. It must provide the services within the constraints of Government funding of €13.457 billion while abiding by a recruitment moratorium.
Community schemes will account for some €424 million in savings, including €200 million in drug costs and €114 million in fees, the HSE said. It also highlighted an “aggressive procurement target” for service providers and drug costs.
In terms of services, the executive is targeting a 2 per cent reduction in inpatient activity, offset by a 3 per cent increase in day cases. It said funding reductions to mental health and disability services would be capped at 1.8 per cent and that respite services would be maintained.
Some 60 additional social workers will be employed and home help will remain at 2010 levels.
A shortage of junior doctors (NCHDs) will pose a particular challenge, the HSE said. It also acknowledged particular issues in hospitals in the north east, which will require some cross-transfers of staff between hospitals in order to maintain services until new junior doctors can be recruited.
Mr Magee said the priorities were to maintain the levels of services provided this year and to deliver the cost reduction and restructuring programmes to enable the maintenance of these service levels within the reduced budgets.
In addition, the executive will accelerate its reform programme to reconfigure core services. This will require an “appropriate balance” between hospital and community services as well as best-care models in childcare, disability, mental health and older person’s services, it said.
It also plans to implement the national clinical change programmes and new service developments.
“These are very challenging times in our health and personal social services. In 2011 it will be an immense challenge to operate within the funding and employment constraints in a way that minimises the impact on the quality and range of services to patients and clients,” Mr Magee said.
The service plan could only be delivered “through the collective efforts of the health and social care professionals from all of our care disciplines and services”, he added.
“With the funding and employment constraints, including the impact of the recent exit programme on management and administrative resources, our services are now more than ever dependent on our people to continue to make the extra effort for our patients and clients.”
Mr Magee said he was “enormously encouraged by the leadership, commitment and goodwill” of staff in the health and social care services.
The HSE confirmed that only about 1,700 staff out of a targeted 2,250 have accepted the redundancy package, for which €250 million in Government funding was set aside.
Mr Magee said there would be discussions with the Departments of Health and finance on any adjustments required once the final numbers were known.
He said some of the monies set aside for the exit scheme would not now be used, but that this also meant the savings targeted in 2011 would be less than planned.
There was no funding in place for an exit package next year, he added.
The HSE also announced the implementation of its new national clinical programmes. It said a "highly ambitious" plan had been outlined for 2011 in this regard.
The focus will be on standardising care and implementing proven solutions to save lives, prevent complications, remove waiting lists and save money, the executive said.
Minister for Health Mary Harney approved the plan today. She said she had requested that the HSE give "favourable treatment" to disability and mental health services in the budget process.
She had also sought the appointment by the HSE early next year of a clinical lead for paediatric services, to work on the development of the New National Paediatric Hospital and drive the implementation of the national integrated paediatric model of care.
"The lower saving target for disabilities and mental health will ensure an approach to priority services such as respite care which guarantees service availability and responsiveness to the needs of clients and families," Ms Harney said.
She added: “We are asking the health service to deliver at least the same level of services next year with less staff and less money.
"This requires improvements in care pathways and also more flexible work practices in line with the Croke Park Agreement. It is a challenge to everyone working in the health services to focus on delivering the innovation and change required to protect and indeed improve our services for patients.”
The plan will now be laid before both Houses of the Oireachtas.