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Press release

Budget 2022: Minister Donnelly announces €21 billion, the biggest ever investment in Ireland’s health and social care services

  • €250m to reduce acute hospital and community waiting lists
  • €45m to advance the Sláintecare objective that care is accessible and affordable for the most vulnerable
  • €31m in new funding for specific women’s health measures, with a further €16m provided across a number of other developments for a total of €47m
  • €36.5m for a range of measures to deliver safe, quality and patient-centred care
  • €62m in new development funding for our National Clinical Strategies
  • €30m in new funding for health services for our older people
  • €65m in new funding for disability services including €10m once-off COVID-19 funding
  • €30m in new funding for health services for our older people
  • €34m in new funding for Mental health services including €10m once-off COVID-19 funding
  • €10.5m for an additional 19 critical care beds in 2022 bringing the total to 340, an increase of 85 since the start of the pandemic
  • €9m to fund Accessible Contraception for Women aged 17-25

Minister for Health Stephen Donnelly TD said:

“Having come through the greatest challenge that ever faced our health system, Budget 2022 will continue to build a health service we can all be proud of. The funding allocated to Health in Budget 2022 demonstrates the government’s commitment in the Programme for Government to deliver Universal Healthcare in a number of important areas.

“My most urgent health priority for 2022 is taking immediate action to address waiting lists which are unacceptably high at present. My department, the HSE and the National Treatment Purchase Fund are working on a Multiannual Waiting List Plan to address waiting lists, bringing them in line with Sláintecare targets and addressing the significant backlog in waiting lists arising from the impact of COVID-19 in the past 18 months in both hospitals and community health services."

The Minister continued:

“Investing in women’s health has been a priority for me since taking office and I am committing €31 million in new measures next year. This will see the phased introduction of free contraception, starting with women aged 17-25. Measures addressing period poverty, expanding clinics for endometriosis and menopause are also being funded.

“For people and families across Ireland, Budget 2022 will address health inequalities and substantially ramp up the resources allocated to programmes that impact on all our health and wellbeing, including access to healthcare, affordability and provision of timely diagnostic services– embodying the Sláintecare principles of delivering the right care, in the right place at the right time."

Minister of State with responsibility for Disability Anne Rabbitte TD said:

“Budget 2022 has seen an additional investment of €65 million added to the €2.2 billion Disability budget, which will further strengthen the delivery of a multitude of supports and services for people with disabilities, inclusive of €10m for once off COVID-19 measures in 2022.

“Building on the success of the 92% reduction in the Assessment of Needs backlog this year, my focus over the next 12 months is to increase access to timely early intervention services through investment for the recruitment of therapists and admin support to the newly established 91 Children’s Disability Network Teams. This will be combined with other wait list initiatives such as investment in digital health technologies, which will, over the course of the year, hopefully reduce the length of time children are waiting to access these vital services.”

Minister Rabbitte continued:

“I will also be increasing the delivery of respite houses around the country on 2021’s targets, as well as the delivery the single biggest increase in Personal Assistant Hours in recent years, equating to 120,000 extra hours being made available, which will help deliver greater independence to those utilising PAs.

“I aim to build on this year’s pilot to transition inappropriately placed Under-65s in Nursing Homes into the community, as well as continuing to fulfil the government’s commitment to reduce the number of people in congregated settings and increase the availability of residential places for persons with a disability.”

The Minister added:

“I am also delighted to announce that there is a once off allocation of €10 million to be spent by the end of this year covering the areas of transport and assistive technology. The former will facilitate the upgrading of service provider buses, while I will also make available funding for assistive technologies to assist services and supports offered to people with disabilities.”

A total of €1.149 billion has been allocated to mental health in Budget 2022. This is an additional €47 million for next year and comprises €24 million for new developments, €13 million for existing levels of service and €10 million in once off funding for COVID-19.

Minister of State with responsibility for Mental Health and Older People Mary Butler TD said:

“This investment will ensure significant developments in mental health services next year. It includes an additional €1.15 million to continue the roll out of specialist eating disorder teams in CHOs 1, 3, 5 and 6, and further funding for the clinical programmes on ADHD, Self-Harm, Dual Diagnosis and Early Intervention in Psychosis. New mental health services for older people will be also developed, in line with the model of care for specialist mental health services for older people and will be piloted next year.

“Out of hours supports will continue to be developed with investment of over €1.4 million in crisis resolution teams next year, in addition to two new Child and Adolescent Mental Health Service (CAMHS) telehubs. Enhancing the capacity of community mental health teams, with a particular emphasis on CAMHS is being prioritised with a total allocation of €6 million. Investment is also being made in recovery focussed supports, including peer supports, employment supports and recovery colleges."

Minister Butler continued:

“A total of €2.33 billion has been allocated to older persons services in Budget 2022, including €30 million for new developments. The €150 million funding secured in 2021 for 5 million additional hours of home support has been maintained for 2022. Furthermore, the proportion of these new home support hours that will be ring-fenced for people with dementia will more than double from 5% in 2021 to 11% in 2022.

“€7.3 million of the new developments investment will allow for the further improvement of dementia services, including in the areas of memory assessment and support services, memory technology resource rooms, the implementation of the dementia registry and dementia audit within acute hospitals and the national intellectual disability memory service.”

The Minister concluded:

“€17.6 million will be allocated for the continued implementation of the recommendations of the COVID-19 Nursing Homes Expert Panel Report including, enhanced Community Support Teams, safe staffing and safeguarding of residents. Developments will also be progressed in the areas of falls and fractures liaison services, intensive home support packages and the Nursing Homes Support Scheme (Amendment) Act 2021.”

Minister of State with Responsibility for Public Health, Wellbeing and the National Drugs Strategy Frank Feighan TD said:

“Today, in Budget 2022 I am announcing an investment of €16m for new measures to support Healthy Ireland and the National Drugs Strategy, with a further €13m allocated under COVID-19 specific funding. The €10m in additional funding for Healthy Ireland, a vital Sláintecare initiative that empowers people to take responsibility for their own health and wellbeing and supports individuals and communities to live healthier lives, includes funding for our Obesity Policy and Implementation Plan, healthy eating policies, and the National Physical Activity Plan.

“Specific initiatives for 2022 are a healthy weight campaign, an innovative coordinated approach to encouraging physical activity through Sport Ireland and the HSE and funding for the expansion of the HSE’s pilot online STI testing programme.”

Minister Feighan added:

“I am announcing €6m in funding to strengthen the health-led approach to drug use in the National Drugs Strategy. This funding will increase access to and availability of drugs and alcohol services, expand the Housing First programme for people who are long-term homeless and have complex health needs, develop harm reduction responses to high-risk drug use associated with crack cocaine and the night-time economy, and enhance child and family services for children and young people affected by parental drug and alcohol use.

“I have also secured €10m in COVID-19 funding to maintain public health measures and consolidate improvements in health services for people who are homeless. A further €3m is being provided to Healthy Ireland in 2022 for COVID-19 related health promotion measures.”

Budget 2022 in figures

Progressing Sláintecare

Delivering Sláintecare on a phased basis requires a consistent focus on progressing three key dimensions: Access, Quality and Affordability. Estimates 2022 delivers on each of these priorities.

Access and Capacity measures

Funding of €10.5m is provided for an additional 19 critical care beds in 2022 bringing the total critical care beds to 340 in line with the 2018 Health Service Capacity Review target to increase this to 430 by 2031, representing a significant increase of 85 beds since the start of the pandemic. €8m is provided to modernise and build up the capacity of our National Ambulance Service as the pivotal first contact for so many of our citizens requiring health care. In addition, €22m is provided for additional Winter Plan measures during 2022.

There will also be significant enhancements delivered in 2022 in other key capacity areas including acute hospital beds, community health networks, home care packages, community beds and rehabilitation beds which build on the strategic expansion begun in 2021. Specifically, Budget 2021 funded in excess of 2,500 additional beds across critical care, acute hospitals, sub-acute and community settings. Over 2,200 of these beds will be delivered by the end of 2021, with the balance scheduled for delivery during 2022.

Quality measures

Clinical governance systems are a critical component of overall governance for the delivery of safe, quality and patient-centred care and it is critical that we continue to strategically invest in enhancing the quality and clinical safety of our health services. In addition to the specific funding noted below for national strategies, €36.5m is provided in 2022 for a range of measures.

The Safe Staffing Framework is an evidence-based approach to determine the nursing requirement, based on patient care needs, across a range of clinical settings. Phase 2 of the Framework will deliver reduced patient time in emergency care settings and better outcomes for patients and staff while Phase 3 is in development for nursing home settings with 9 pilot sites selected for the testing of an evidence-based model. Funding is also provided to expand the Advanced Nursing and Midwifery workforce to a target of 2.3 % of the total Nursing and Midwifery workforce in 2022. Advanced Nursing and Midwifery roles have been shown to reduce waiting lists and integrate care between the hospital and community settings.

Finally, 2022 will see implementation of the recommendations of the Nursing Home Expert Panel.

Affordability measures

A central tenet of Sláintecare is that health services will progressively move to being provided free at the point of delivery, based entirely on clinical need. Funding of €45m is provided in 2022 for a range of measures to advance this objective and specifically to ensure that care is accessible and affordable for the most vulnerable in our society. These measures include expanding access to free GP care to children aged 6 and 7, a range of oral health measures, reducing the monthly threshold for the Drug Payment Scheme from €114 to €100 as well as moving on a phased basis to reduce the financial burden of hospital charges for children under 18.

Waiting Lists

For 2022, an additional allocation of €250m, comprised of €200m to the HSE, and €50m to the National Treatment Purchase Fund (NTPF) has been provided in respect of the ongoing work to reduce acute hospital and community waiting lists bringing the overall allocation for waiting list measures to €350m. The additional €250m, which is being provided from COVID-19 funding in 2022, will be used to fund additional activity in the public and private sectors, including expanding access for General Practitioners to diagnostics.

This will deliver an immediate reduction in waiting lists while continuing the reforms required to achieve the longer-term goals under the Sláintecare multi-annual waiting list plan. The €50m allocated to the NTPF brings the overall allocation for NTPF to €150m for 2021.

Winter Plan

The Health sector is expecting to face significant challenges this Winter in providing emergency care in dealing with COVID-19 in addition to the normal challenges of the Winter period. Significant investment of €1.2bn was provided in budget 2021 to expand capacity, increases services and support reform and this level of investment is being maintained in budget 2022. An additional €22m is also being allocated in this budget to enhance specific additional winter initiatives in 2022. HSE plans will ensure that the health service is prepared for the challenges of Winter 21/22, building on the significant investment in additional capacity delivered during 2021, to support a significant sustained improvement in Emergency Department performance.

Women’s Health

Budget 2022 provides €31m in new funding for specific women’s health measures to underpin a fully funded Action Plan in Women’s Health for 2022 linked to 3 major objectives:

  • implementing national strategies that will improve the foundations for women’s health – seen in additional funding for maternity, obstetrics, gynecology services, and perinatal genetics
  • tackling the issues that women have said they want to see improved – seen in additional funding to make contraception freely available to women aged 17-25 and increased investment in a new approach to menopause care
  • funding innovative new approaches to women’s health – seen in an allocation of €10m provided to the Women’s Health Fund funding and for example, investment in targeted for projects like the roll-out of initiatives to address period poverty

In addition, a further €16m in other measures to support women’s health is embedded within other new measures for 2022 within the Health Vote in areas such as cancer, mental health and social inclusion budgets, bringing the overall investment in women’s health to €47m in additional funding provided for 2022.

National Strategies

National and clinical strategies continue in 2021 to underpin and define the system reform roadmap for the Irish health system over the next decade, in line with Sláintecare. Following a very significant investment in health strategies in 2021, which has already yielded service enhancements across a wide number of specialties, further additional funding is being provided in 2022 to accelerate the implementation of the following:

  • National Cancer Strategy 2017-2026
  • National Maternity Strategy 2016-2026
  • A Trauma System for Ireland as well as strategic investments in the two National Trauma Centres (Mater Hospital Dublin and Cork University Hospital)
  • Model of Care for Ambulatory Gynaecology
  • Model of Care for Infertility
  • Paediatric Model of Care including Children’s Health Ireland and Regional Paediatric Units
  • organ donation and transplant initiatives
  • the Women’s Health Taskforce
  • Taskforce on Staffing and Skill Mix for Nursing
  • National Positive Ageing Strategy
  • Housing Options for our Ageing Population
  • National Dementia Strategy

Health Workforce

Budget 2022 reinforces the commitment to significantly expand the health sector workforce. Last year’s Budget made funding available for a large expansion of the health sector which has seen it grow by 4% so far in 2021. This large expansion will continue in 2022 and Budget 2022 allows for the workforce to expand by 6% above projected end year figures. It is estimated that the workforce will grow further by 8,000 WTE in 2022. This growth has and will continue to be seen across all service areas and all staff categories.

Disabilities

An additional €65m is being provided in 2022 for Disability Services including €10m once-off COVID-19 funding. The increased level of funding will build on initiatives currently underway, including addressing the new cohort of approximately 1,700 young people with disabilities who will leave school and training programmes during 2022 and will need assessment for supports and services. There will also be a renewed focus on addressing the inappropriate placement of young people with disabilities in nursing homes.

In addition, investments are funded in residential, respite and personal assistance services and delivering the ‘Progressing Disability Services for Children and Young People’, which will increase therapeutic staff under the newly established Children’s Disability Network Team Network model. This will reduce waiting lists for access to assessment of need and increasing access to timely early intervention services.

Mental Health

€24m is provided for new development funding within mental health aimed at prioritising early interventions and improving access to person-centred mental health services, including provision for the recruitment of over 350 additional posts in Mental Health services, the continued development of vital national clinical programmes in eating disorders, ADHD, early intervention psychosis, self-harm and dual diagnosis. Increasing numbers of older people means more older people with complex mental health difficulties requiring specialist support.

A Model of Care for Specialist Mental Health Services for Older People will be advanced. Similarly, the Perinatal Model of Care will be further developed. Finally, the funding will also enable the further development of two Child and Adolescent Mental Health Hubs and important out of hours services through crisis cafes and crisis resolution services.

Older Persons and Dementia

2022 will bring further enhancement of services and supports for older people, building on the unprecedented increase in funding in 2021 with a further investment of €30m. Dementia services and supports will be improved by prioritising service development, quality improvement and clinical practice including supporting the implementation of the dementia registry and dementia audit within acute hospitals.

Funding will be allocated for the continued implementation of the recommendations of the Expert Panel Report on Nursing Homes including, among others, the establishment of a permanent multi-disciplinary, enhanced Community Support Team in each Community Healthcare Organisation area and the pilot of the Safe Staffing Framework for long-term residential care. Investment is also be being made in Falls/Fractures liaison services, intensive home support packages and the operationalisation of the Nursing Homes Support Scheme (Amendment) Act 2021.

Drugs/Social Inclusion/Healthy Ireland

€16m is provided for new measures to support Healthy Ireland and the National Drugs Strategy. A further €13m is being allocated under COVID-19 funding. Healthy Ireland is being provided with €10m in additional funding and will implement a healthy weight campaign and an innovative coordinated approach to encouraging physical activity through Sport Ireland and the HSE. The funding is also being used to the scale up the HSE online STI service.

€6m is provided under the National Drugs Strategy. This funding will increase access to drugs and alcohol services, expand the Housing First programme and enhance health services for vulnerable children and young people.

€10m in COVID-19 funding is provided in 2022 to maintain public health measures and to consolidate improvements in health services for people who are homeless and €3m is being provided to Healthy Ireland in 2022 for COVID-19 related health promotion measures.

COVID-19

Budget 2022 provides up to €500m for a range of Public Health Measures related to the health service response to COVID-19, including €400m allocated to the Department of Health and €100m held in central government contingency. Funding of up to €100m is being provided for the purchase of Personal Protective Equipment (PPE) in order to maintain minimum stock levels, to ensure that there will be no shortages of PPE, that all healthcare professionals will have the protection they need and to provide for continued investment in indigenous manufacturing, ensuring security of supply in the event of further international shocks.

Funding of up to €150m is being provided to Testing and Contact Tracing to ensure that Ireland retains a comprehensive, reliable and responsive testing and tracing operation in 2022. This relates to all associated costs including swabbing, laboratory tests, contact tracing, antigen testing and relevant logistics including associated ICT costs. Funding of up to €250m is being provided to allow for the continuation of the Vaccination Programme in 2022, including implementing a Booster Programme for population cohorts based on the latest available medical advice from the National Immunisation Advisory Council (NIAC), taking into account the most recent international guidance.

As well as the funding of €500m, inclusive of €100m held in central government contingency, provided for Public Health Measures, a further €100m is allocated for other recovery and resilience measures in response to COVID-19 across the health system. The overall COVID-19 allocation will also support specific allocations of €10m each in relation to mental health, disabilities, social inclusion (including the National Drugs Strategy) and €3m to the Healthy Ireland programme.

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