I propose to take Questions Nos. 39, 183, 188 and 191 together
The Deputy's questions should be considered in the context of a total gross Estimate of almost €10.08 billion for the health services in 2004. This is a significant milestone in funding and demonstrates the considerable investment made by this Government over the past number of years in this country's health services. The figure of €10.08 billion consists of €9,570 million current funding and €510 million capital funding. With regard to day to day spending, this represents a €926 million or 10.7% increase over last year's Revised Estimate and a €782 million or 9% increase over the outturn for 2003, the largest increase in funding received by any Government Department this year.
Responsibility for human resource planning rests with the chief executive officer, CEO, of each board. Each CEO in managing the workforce in his/her region is responsible for determining the appropriate staffing mix and the precise grades of staff to be employed in line with service plan priorities, subject to overall employment levels remaining within the approved regional employment ceiling. Staffing requirements in the areas highlighted by the Deputy should be viewed in light of the substantial increases in employment levels achieved in the health service overall in recent years. Developments such as pay increases, improvements in career structure and enhanced opportunities for professional and career development have all supported increased staffing levels for key health and social care professions. Total staffing figures for the public health service increased from about 68,000 in 1997 to approximately 96,000 by the end of 2003, which represents a 40% increase.
I am confident that the extensive range of measures, including the substantial increase in training places, the recruitment of overseas nurses, the more effective utilisation of the professional skills of nurses and midwives, in addition to close monitoring and assessment of the situation on an ongoing basis will continue to prove effective in addressing the nursing workforce needs of the health services.
I am well aware that in addition to effective planning to ensure the continued availability of a qualified, competent workforce, it is also necessary for the health service to become an employer of choice to further improve potential for recruitment and retention. While the record number of staff recruited into the health service in the past number of years shows the progress that has been made in this regard, even more can be achieved. Having recruited and developed such a large number of staff over recent years, it is a priority to retain them by offering a challenging and rewarding career path.
As far as medical personnel are concerned, the recently published report of the national task force on medical staffing or Hanly report details the number of consultants and non-consultant hospital doctors that will be required in the coming years to provide a high quality, consultant provided service. The report recommends an increase of approximately 1,800 consultants employed in the public hospital service over the next ten years. As of January 2004, there were 1,831 consultants employed, which represents an increase of 41% in the last six years. Hanly recommends that there be 3,063 consultants in place by 2009 and 3,625 consultants by 2013.
The acute hospital system is providing more and better services than ever before. Activity in our acute hospitals continues to rise. The number of patients discharged from hospital having been treated as either an in-patient or as a day case in 2003 was over 1 million. This is the first time that the number has exceeded 1 million and represents a 4.7% increase over 2002. This also represents a 27% increase on the number of patients treated compared to the 785,700 treated in 1997. The increase in acute hospital activity is as a direct result of this Government's investment in capacity and staffing.
The current delivery system is now providing a high quality service, backed by a dedicated and skilled workforce and supported by a significant funding base. This Government, through its consistent approach to prioritising health and health issues, has provided this significantly enhanced resource base.
