Increases come with conditions

Health spending will rise substantially next year, but the funding comes with a warning that the system must reform itself to…

Health spending will rise substantially next year, but the funding comes with a warning that the system must reform itself to provide better value for money.

Announcing a rise of 13 per cent to €7.7 billion (£6.1 billion) the Minister for Finance said yesterday that the health services must put a new focus on delivery of services and not just on getting extra money "as has hitherto been the case."

"The challenge for the health services now is to put the necessary organisational and management changes in place in order to demonstrate that the service being provided not only meets public expectations but also represents value for money to the taxpayer," Mr McCreevy said.

But hospitals were later defended by the Minister for Health and Children.

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Mr Martin said an extra 52,000 people had been treated by the hospitals this year bringing the total to 920,000, an increase of 6 per cent in productivity.

The net increase of €808.6 million in health spending next year includes provision for measures to be included in the forthcoming national health strategy.

These measures are expected to be published next week or early the following week.

Mr McCreevy said yesterday the measures would be a continuation of existing ones, which were already underway.

Mr Martin said he wished to acknowledge "this significant increase, particularly at this time of retraction within the economy."

An extra 2,500 people are to be employed in the health services next year. Currently 88,000 people work in the health services compared to 66,000 in 1997.

The extra spending provided for in the Estimates also includes the following:

Acute Hospitals: €94 million. To include new units, cancer prevention and treatment, Winter Initiative (involves taking contract beds in nursing homes) and increases in hospital bed numbers.

Childcare Services: €35 million. To include foster care, youth homelessness, National Children's Office, implementing the Children Act 2001, implementing the Children First guidelines for dealing with child abuse and the inter-country adoption service.

Community Care: €101 million. Includes mental health, intellectual disability and autism, physical and sensory disability, services for older people and assistance with the cost of nursing home care.

Primary Care: €51 million. To include dental services, immunisation programmes, AIDS/HIV and drug services, food safety programmes and general practitioner co-ops.

Introduction of nursing degrees in 2002: €51.5 million. To include equipment, building and pay costs and to increase the student intake from 1,500 to 1,640.

The estimates received a cool welcome from the Irish Medical Organisation which said the increase "will have little or no impact on alleviating the current crisis in the health services."

The organisation repeated a call for the immediate development of a "crisis plan" to support the health strategy.

The proposed increase "will do little more than maintain the current level of service being provided and this is already stretched to breaking point," said IMO president, Dr Mick Molloy.

The Labour Party finance spokesman, Mr Derek McDowell, said it was "important to note that we have now had two years of substantial increases in the health budget; we are yet to see the Government's long awaited health strategy."

The Minister hinted yesterday that health boards may be given discretionary budgets which can be used either to pay for nursing home care or else to pay for services to enable an older person to continue living at home.

What older people wanted was to live at home and not to be institutionalised.

There had been a 25 per cent increase in the nursing home subvention last year "but a lot of nursing homes simply increased it again," he said.