Dáil Éireann Debate, Thursday - 9 November 2023
16. Deputy Martin Browne asked the Minister for Health the level of additional core expenditure for new developments, excluding funding for carry-over and otherwise maintaining existing levels of service, which has been allocated to Tipperary University Hospital for 2024; and if he will make a statement on the matter. [49064/23]
Amharc ar fhreagraI thank an tAire for taking the question. Before I start, I also congratulate Deputy Troy on the new arrival. The fun starts now for him.
I raise this question in light of the fact that €708 million in funding has been allocated for existing levels of service in 2024. That is less than half the shortfall identified for 2023, and that is even before covering other pressures in 2024 as a carry-over and demographics and pay. I would like to know where Tipperary University Hospital fits into the terms of this and the impact on any new developments taking place there and the maintenance of existing levels of service.
I thank the Deputy for his question and join him in acknowledging the work that Tipperary University Hospital does. The hospital has gone from strength to strength in serving the needs of the population.
There has been, as he will be aware, a very big increase in the amount going into the hospital from the Government, and rightly so. In fact, the budget has gone up nearly 30% since 2019. That has helped the hospital to hire an additional 270 healthcare professionals, who are making a big difference in the care being delivered. I am delighted that the additional capital investment in the hospital will provide an extra 33 inpatient beds in the newly developed unit. This new unit is planned to reduce the number of patients who end up on trolleys in the emergency department. That will also help the hospital to reconfigure beds internally and give the older people of Tipperary, who make up nearly half of all inpatients there, greater access to inpatient services at the hospital. I imagine the Deputy will join me in welcoming that development at the hospital. It will make a big difference.
Additional funding specific to the hospital will be determined through the ongoing process. I will shortly issue a letter of determination to the HSE. It will then develop a detailed national service plan for consideration. That will be where we will see its proposals on a hospital-by-hospital basis in terms of the level activity and, therefore, requisite funding to be allocated.
I appreciate that work is going ahead there and that there is funding there. It is, however, beyond unacceptable, at a time the pressure on all our hospitals is at its greatest, that the hospital is now faced with tightening its belt even further, with the added complication of it being unsure precisely what the impacts of the cuts will be. The year began with a total of 2,467 scheduled care cancellations and, as the year progressed, the hospital has been continuing to deal with the increase in presentations and admissions. Thankfully, however, it does not plan to close any inpatient beds due to the funding shortfall. I commend the hospital on that and on the work it has been doing. Staff did note, however, when we talked to them - and this will come as no surprise locally or to anybody else - that they have been operating at 100% capacity daily. That they are being forced to operate in that manner is unfair on them given the pressure they are under. It also poses issues for patients because it presents little room for any manoeuvre in those situations. The uncertainty with the funding just adds extra pressure that neither staff or patients should be under. Currently, the hospital has a small number of projects, which the Minister will be aware of, that are working through the capital steering process. Can I get a guarantee that those will not be affected as a result of the shortfall in funding?
Any projects working their way through the process will be assessed on a project-by-project basis, as they always have been. When we look at Tipperary, Clonmel, the hospital there and the county as a whole, what we see in terms of health services is a story of more and better services being provided. We have gone through the very big increase in funding, staff and services for Tipperary hospital. We have talked about the extra beds and the big difference they will make. As the Deputy will be aware, at the same time there has been a big increase in investment in community services, new primary care centres, new primary care teams, new older persons teams and new chronic disease management teams. When all that is combined, the story of healthcare in Tipperary, while we have a long way to go, as we do across the country, is one of progress and of our healthcare professionals providing more and more and better services to the people of the county.
I am confident that the management will do all it can to maintain the existing levels of service there. It is committed to advocating for the community locally and for the service demands to meet people's needs. We need, however, to hear the same commitment come back from the Government on this. The Minister mentioned primary care centres. I have brought up several times here, as we have brought up locally, the matter of primary care centres trying to get doctors into them in the first place. I had a case recently in which a woman went to a primary care centre at 4.30 p.m. only to be told, "No, we finish at half four because we are out the door at five." That is no good. Unless these primary care centres are up and running properly, it will always add pressure to the accident and emergency departments.
To conclude on this, the hospital has also acknowledged to me that the recruitment freeze has the potential to have a negative impact on patient care. The Minister himself spoke about how well they have been working. The longer the freeze and the more money the Department takes out of the system - and the recruitment freeze itself is adding pressure on the system as it is - the more likely it is at some stage to collapse. How does a recruitment freeze on healthcare workers in the community square with the role of taking pressure off our emergency department?
We are way over time.
I will make one last point about home care. I have a situation in Carrick-on-Suir involving a family, a man and a wife, depending on their neighbour for home care. She has applied since May and cannot even get an answer back as to whether or not that family can have home care. If I give the Minister the details, will he look into it for us? That family is depending on a neighbour who is working-----
Deputy, we are way over time. Go raibh maith agat. I call the Minister.
I certainly will look into it. The Deputy can give the details to me or the Minister of State, Deputy Butler, and we will certainly take a look. The Minister of State and I are very much aware that while there are millions more home care hours being delivered and they are providing an awful lot of support to individuals and families right across the country,l a little more than 3,000 people have been approved for funding and are waiting. The Minister of State led a really important new contract that has been taken up, which improves the terms and conditions for home carers.
It sets out a minimum base for the living wage and it has payments for travel time. Our aim is to go from 21.5 million hours delivered this year to adding another 0.5 million hours next year as well. Our hope is that is exactly the kind of expansion that will help the families the Deputy references, who we are acutely aware are in need of that support.
