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Health Services Expenditure

Dáil Éireann Debate, Tuesday - 14 May 2013

Tuesday, 14 May 2013

Questions (121, 144, 704, 708)

John McGuinness

Question:

121. Deputy John McGuinness asked the Minister for Health his views on whether the Health Service Executive will reach its budget targets for 2013; and if he will make a statement on the matter. [22607/13]

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Robert Troy

Question:

144. Deputy Robert Troy asked the Minister for Health his views on whether the Health Service Executive will reach its budget targets for 2013; and if he will make a statement on the matter. [22616/13]

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Bernard Durkan

Question:

704. Deputy Bernard J. Durkan asked the Minister for Health if he will give an assurance that budgetary cuts he and his Department are forced to undertake arising the Memorandum of Understanding will not damage the structure of the health services to such an extent as to make the delivery of services impossible; if he will carefully review the needs and requirements of each sector throughout the health services in this regard; and if he will make a statement on the matter. [23020/13]

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Bernard Durkan

Question:

708. Deputy Bernard J. Durkan asked the Minister for Health the extent to which it is intended and expected to apply savings across the health services in such a way as to ensure that extra cost-cutting is not required towards the end of the year; and if he will make a statement on the matter. [23024/13]

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Written answers

I propose to take Questions Nos. 121, 144, 704 and 708 together.

2013 is another challenging year for the Health Sector and the Government had to take a number of tough measures to ensure that the most vulnerable were protected and front line services maintained to the greatest extent possible. The health services has already achieved significant progress in “doing more with less” and in providing various flexibilities in line with the Croke Park agreement to date. There has been a significant reduction in the cost base of the health services over the last few years, and yet the level of service has either been maintained or increased. We are cutting the cost of services, not the services. Even after the considerable reduction in the cost base over the last few years, further substantial cost extraction is required, with €781m in savings to be achieved this year. Significant savings have been targeted in relation to the cost of prescribed drugs and medicines. A new agreement with the Irish Pharmaceutical Healthcare Association will provide savings in excess of €400m over the next three years. This will mean significant reductions for patients in the cost of drugs, as well as a reduction in the drugs bill to the State.

The level of health services to be delivered within the available funding is set out in the Service Plan. The Plan also sets out the measures required to fund unavoidable pressures and commitments made under the Programme for Government. Significant reductions in drug expenditures will be required and maximising the potential for pay savings under the Croke Park Agreement is critical in achieving the savings target. Every budget holder must achieve the expenditure targets set at the start of the year, and in line with the National Service Plan, the Regional Service Plans were prepared in the context of the challenges faced by the health services in terms of reduced staffing levels, and a reduced budget, combined with increasing demand for services.

My Department, the Department of Public Expenditure and Reform and the HSE are working collaboratively on the Financial Improvement Programme with a view to strengthening the Health Service Executive's financial and performance management and reporting systems during 2013. Notwithstanding this, there is ongoing and intensive engagement each month between officials from my Department and the HSE in the context of regular monitoring of expenditure. The HSE's Performance Report, which is published every month, provides an overall analysis of key performance data from Finance, HR, Hospital and Primary & Community Services. The activity data reported is based on Performance Activity and Key Performance Indicators outlined in the HSE National Service Plan.

The position at the end of the first quarter is showing a €27m deficit in income and expenditure terms. When account is taken of timing issues around the phasing of budgets and the shortfall in retirees to date , there is a core deficit of €11m. Projections to year end based on 1st Quarter data are being finalised by the HSE at present, in tandem with the detailed assessment of performance. The scale of the risk and challenge in achieving financial breakeven by year end remains significant as predicted in the NSP 2013 and will increase if there is an absence of continued and improved flexibility under the Croke Park Agreement.

Question No. 122 answered with Question No. 116.
Question No. 123 answered with Question No. 97.
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