The previous government maintained its commitment to investment in health services during its term. Each year the Health Service Executive sets out in its National Service Plan the allocation of the funding received from government for the delivery of health services for the year.
The amount allocated each year follows an extensive process of engagement between my Department and the Department of Expenditure and Reform, which considered both the funding requirements and the fiscal position. These types of engagements are a normal part of the Budgetary process and happen with Departments across Government. All Departments put forward spending proposals but are required to operate within the amounts proposed by Government and determined by the Dáil.
The issue of health funding is a major policy challenge for both the Irish and international Governments. Despite welcome increases annually, the need for effective financial management remains crucial as the health service deals with a larger and older population, with more acute health and social care requirements, increased demand for new and existing drugs and the rising costs of health technology. The costs associated with these service pressures will increasingly need to be managed not solely through annual increased Exchequer allocations but also through improved efficiencies, productivity and value from within the funding base.
Funding is provided to the HSE for Health services in accordance with the letter of determination which sets out the approved level of overall HSE expenditure for the year in question.
From the table below you can see the majority of the funding for the period 2017 to 2020 has been allocated to pay cost pressures and maintaining existing levels of service, taking account of demographic changes. These allocations are balanced with new developments seeking to continuously improve the Irish health system and the growing costs arising from pensions and the state claims agency.
2017 saw the commencement of the unwinding of the savings delivered under the Financial Emergency Measures in the Public Interest Act 2009; this combined with other national pay agreements since 2016 has had a significant impact on the funding required to address pay cost pressures annually.
Significant funding is also allocated towards maintaining existing levels of service.
Description
|
Increase in 2016
|
Increase in 2017
|
Increase in 2018
|
Increase in 2019
|
Increase in 2020
|
HSE
|
€m
|
€m
|
€m
|
€m
|
€m
|
Pay Cost Pressures
|
59
|
174
|
278
|
287
|
276
|
ELS/Demographics
|
401
|
244
|
491
|
254
|
430
|
New Developments
|
137
|
81
|
196
|
199
|
168
|
State Claims and Pensions
|
139
|
154
|
96
|
107
|
133
|
HSE Total
|
736
|
653
|
1,061
|
847
|
1,007*
|
* An additional €50m for new developments was included in the original Revised Estimate for 2020 in addition to the allocation provided in the Budget 2020 Expenditure Report. Provision was also made in relation to preparation for the impact of Brexit.