I propose to take Questions Nos. 224 and 240 together.
Based on the existing drawdown on its Vote, the Health Service Executive is forecasting a shortfall in Vote terms of €450-€500m, with the Executive indicating that hospital activity, expenditure in the Primary Care Reimbursement Service and higher than planned superannuation costs being the significant factors.
Given the extent of the projected overrun, further cost containment measures will have to be introduced over the course of the rest of the year. My Department has been working closely with the HSE to identify the measures necessary to ensure that it balances its budget and achieves a balanced vote. Following intensive discussions with my Department, HSE senior management has instructed regional management this week that hospital activity must be brought back in line with service plan targets. In addition the HSE must deliver on its other service plan targets at national and regional levels, with a renewed focus on reducing absenteeism, agency costs and overtime. The HSE will also begin putting probity measures in place to achieve more cost-effective and clinically appropriate usage of approved drugs. Management has also instructed the regions to ensure that patient safety and quality issues are addressed when activity levels in hospitals are being aligned to service plan targets.
The HSE will also seek to reduce and eliminate budget deficits while minimising the impact on front line services by fast tracking new, innovative and more efficient ways of using reducing resources. New models of care will be introduced across all services, which will treat patients at the lowest level of complexity and provide quality services at the least possible cost. The roll-out of the National Clinical Care Programmes and Special Delivery Unit initiatives will also deliver greater productivity.
At the beginning of this year, I informed the House that 2012 would be a very challenging year for the health services. The HSE's Service Plan was framed so as to protect frontline services to the greatest extent possible within the resources allocated to it. I believe that if the HSE successfully addresses the issues I have outlined, the objective of the National Service Plan will be achieved.