Select Committee on Health: Opening Statement by Minister for Health Stephen Donnelly - Consideration of the 2022 Revised Estimates for Vote 38 (Health), Thursday 24 February 2022

Check against delivery

Chairman, members of the Select Committee.

I welcome this opportunity to address the Select Committee on the Revised Estimates for 2022 for my department (Vote 38). I am delighted to be joined by my colleague Mary Butler, Minister of State with responsibility for Mental Health and Older People.

Budget 2021 saw an unprecedented allocation of over €4 billion in additional funding for Health. This funded COVID-19 responses, maintaining the existing level of service, but critically €1.16 billion of this funded vital capacity and reform measures. This included unprecedented numbers of additional beds, workforce expansion, home care hours and investments in national strategies.

We are all aware that 2021 was a difficult year with significant impacts from COVID and the need to deliver the Vaccination programme. This has meant that not all of these new measures could be delivered in 2021. We estimate that approximately €650 million of the €1.16 billion was spent in 2021.

However, I am pleased that, as we enter a new phase in the COVID-19 pandemic and plan to scale back our emergency COVID-19 expenditure, Government has made the full amount of funding available again in 2022, together with €319 million of additional funding for new measures. This means that there is a further expansion of over €500 million from 2021 new measures still to be delivered in 2022 bringing the total available for additional capacity and reform to over €800 million for 2022.

This will fund an expansion of our workforce of up to 10,000 staff, over 300 additional acute beds, 3 million additional home care hours and the full rollout of the Enhanced Community Care teams to move delivery of care out of Acute settings and into Communities

I have mentioned previously my three priorities as health minister:

• improving access for patients
• improving outcomes for patients
• improving the affordability of health care for patients

This Revised Estimate continues the work done in delivering on all three.

• addressing waiting lists by allocating an additional €200 million to the HSE and an additional €50 million to the NTPF
• I am providing funding for additional critical care capacity, with funding to open 19 additional critical care beds. This is on top of the substantial funding of €426 million provided in 2021 for overall bed capacity

The level of funding provided will enable the advancement of a number of priorities in 2022 including:

• prioritising funding for Women’s Health issues. I have allocated an unprecedented amount of €47 million towards investment in Women’s Health. This will allow my department to introduce a number of key measures, including:

- free contraception, initially for women aged 17-25 years’ old;

- increased investment in a new approach to menopause care;

- €10 million provided to the Women’s Health Fund for targeted projects like initiatives to address period poverty;

- implementing national strategies that impact on women’s health with additional funding for maternity, obstetrics, gynaecology services and perinatal genetics as well as funding in cancer, drugs and mental health

• I was delighted to announce, only last week, a new plan to reduce treatment waiting times for children with scoliosis and spina bifida
• providing funding for the continued implementation of other National Strategies, including the:

- Cancer Strategy

- National Ambulance Service Strategic Plan

- Trauma Strategy

- Paediatric Model of Care including new children’s hospital

- Organ Donation and Transplant Services

- social care strategies, in the area of dementia and palliative care

• introduce new Regulations and Legislation to expand the remit of HIQA, roll out of InterRai assessments in nursing homes

Budget 2022 responds strongly to the Programme for Government commitment to introduce more care in the community and to make accessing services more affordable. This will reduce our dependence on the hospital centric model of care.

In addition to the strategies mentioned above, I am:

• providing for the extension of free GP care for children aged 6 and 7, benefitting approximately 80,000 additional children
• reducing the Drug Payment Scheme threshold from €114 to €80 benefiting 70,000 people
• actions will also be taken on a phased basis to reduce the financial burden of hospital charges for children under 18
• €30 million for new drugs
• a further €36.5 million for a range of measures including the Safe Staffing Framework, Anti-Microbial Resistance and Infection Control (AMRIC) and the implementation of the Nursing Home Expert Panel recommendations
• €37 million in additional funding for mental health services plus €10 million designated from COVID funding for mental health to a total of €47 million
• €30 million to build on the investment in older persons and dementia services
• an additional €105 million to disability services with a further €10 million in once off COVID-19 funding.
• an additional €10 million for Healthy Ireland
• €6 million for social inclusion including the national drug strategy

2021 outturn

The gross provision for the Health Vote in 2021 was €22.1 billion, comprising €21.1 billion current expenditure and just over €1 billion capital expenditure.

This €21.1 billion represents the gross funding position for both the Department of Health and the HSE and includes additional funding of €1.8 billion made available for current expenditure in 2021 in response to COVID-19.

The initial 2021 capital allocation was €893 million. In response to COVID-19 an additional €155 million was assigned, bringing the total capital allocation that year above €1 billion.

The total cost of COVID-19 supports provided by Government to the Health Service in 2021 was €1.9 billion. These measures continue to be relevant in 2022 as the pandemic continues.

2022 Budget

In framing the 2022 Budget, the Oireachtas allocated further additional Exchequer funding for the health sector - gross health funding is €22.2 billion comprising €21.1 billion in current expenditure and €1.1 billion in Capital.

This represents an increase of €51.6 million (0.24%) on the 2021 Current Expenditure budget (increase of €1.1 billion or 5.9% excluding COVID-19 expenditure) and recognises the government’s commitment to providing a health service that improves the health and wellbeing of the people of Ireland. €319 million of this is allocated to new measures when taken with over €500 million from 2021 new measures still to be delivered in 2022 bringing the total available for additional capacity and reform to over €800 million for 2022.

2022 Capital allocation is €12 million above the final 2021 figure, it represents a significant increase on pre-COVID-19 allocations and will contribute to the delivery of modern health facilities and equipment across the country, both key aspects of Sláintecare and Project Ireland 2040.

2021 was another difficult year for those working in healthcare. Our doctors, nurses, allied health professionals, and everyone across the health service have been working tirelessly throughout this pandemic. The great success of our vaccine rollout has allowed us to move back to a more normal way of living and working.

While COVID-19 has highlighted major challenges in our health services, it has also highlighted our strengths, including the resilience, professionalism, courage and innovative spirit of our healthcare workers.

Budget 2022 funds our ongoing COVID-19 response. But more than that, it is also about building capacity, hiring staff and bringing positive permanent change to our health service.

The continuing investments made in recent years will mean that through the reforms being enacted, Ireland will have a better and more resilient public healthcare service.

Thank you.