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Financial Resolution No. 2: General (Resumed) (Continued)

Thursday, 13 October 2016

Dáil Éireann Debate
Vol. 924 No. 3

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(Speaker Continuing)

[Deputy Simon Harris: Information on Simon Harris Zoom on Simon Harris] In the coming winter the initiative will deliver an additional 950 home care packages, an additional 58 transitional care bed approvals weekly; an additional 55 acute beds and an additional 18 step-down beds, as well as expansion of community intervention teams across four areas of the country and minor injury services in the Dublin area. The winter pressures on hospitals cannot only be resolved by additional provision in acute hospitals. We must also drive down the number of delayed discharges. I accept that there is a need for a bed capacity review and, probably, much more investment in bed capacity, but there are beds in the health service that are being occupied by patients who do not wish to be in them and do not medically need to be in them. For this reason, the focus of the winter initiative and the budget is on home care packages, transitional care beds, step-down beds, community intervention teams and so on. We also need to put in place a new GP contract.

I welcome the additional funding for acute and emergency services, which represents an increase of over €90 million on the revised allocation in 2016. The increased allocations in 2017 for acute hospitals, the National Ambulance Service and the national cancer control programme demonstrate my commitment and that of the Government to driving key policy and strategic initiatives to improve and expand acute care and emergency services for patients. This funding will enable continued progress to be made on initiatives such as the delivery of the new national children’s hospital, implementation of Ireland's first maternity strategy and the winter initiative and drive improvements and expansion in cancer care for patients, ambulance services, waiting lists and paediatric services. We are also making provision for 1,000 new nurses to join the health service. I was pleased to be able to announce today an improvement in the pay of nurses who graduated between 2011 and 2015 by way of the restoration of their increments from January next.

In 2017, in line with the commitment in A Programme for a Partnership Government, we will increase investment in ambulance services. The capacity report identifies significant deficits in ambulance services which we will need to address incrementally in the next few years. Additional funding provided in 2016 has allowed us to start that process and the provision of further additional funds for 2017 will facilitate the development of the intermediate care service. This service focuses on providing transport for low acuity patients, including inter-hospital patient transfers. Through investing in the intermediate care service, we aim to free up the emergency fleet for emergency calls, thus improving the service overall.

On primary care services, it is proposed to progress the delivery of medical cards for all children in receipt of the domiciliary care allowance, as well as the new GP contract that is badly needed. My colleagues will outline other measures.

Minister of State at the Department of Health (Deputy Catherine Byrne): Information on Catherine Byrne Zoom on Catherine Byrne I welcome the €3 million being provided to support drug and social inclusion measures in 2017. This will bring the total funding available to the HSE for social inclusion services to over €131 million. The Department also provides more than €6 million for drugs and local task forces. The additional funding announced in the budget will enable the HSE to continue to provide initiatives aimed at improving the health outcomes of the most vulnerable in our society, including those affected by addiction issues, those experiencing homelessness, Travellers and the Roma community, asylum seekers and refugees. It will also help to fund the national drugs strategy, the pilot supervised injection facility, services for young people under 18 years and detoxification beds for adults. The Government, in providing this €3 million, is committed to a health-led response to the drug problem.

Other areas that come within my remit are housing and homelessness. I welcome the €42.4 million being provided for the social inclusion and community activation programme, SICAP, through which approximately 45,000 people will receive direct one-to-one labour market training and support, 2,800 local community groups will be assisted, 20,000 individuals will receive educational support and 25,000 individuals will receive employment support. I am delighted to announce that €2 million is being made available for the roll-out of a new community development scheme which will be targeted at disadvantaged urban and rural areas and fund projects that seek to enhance communities, address disadvantage and improve social services at local level. My experience during the years has been that very often community groups require small levels of funding to build capacity and get projects off the ground. I hope the new scheme will be the starting block to enable communities that do not often receive funding to begin some work on the ground.

Minister of State at the Department of Health (Deputy Helen McEntee): Information on Helen McEntee Zoom on Helen McEntee This is the first budget of the new partnership Government. It is also the first budget comprised of input from members of all parties and Independents in this House through the Committee on Budgetary Oversight. This is a new and positive move.

The context of the budget is the need for fairness. We must see a matching social recovery to mirror the economic recovery and give people a sense of hope and certainty. That is why the balance of spending is 2:1 in favour of public services. Again, this spending must be prudent and sustainable or we risk giving false hope and having to cut back again if times become tough internationally.

Throughout tough economic times in this country we have continued to invest in mental health services. Between 2012 and this year, funding increased by€150 million, or 16.25%. In budget 2017 the investment of recent years in mental health services will be consolidated and increased. I am pleased to say €35 million for new services will be initiated in 2017. This is in addition to the €35 million provided in 2016 which remains in the base of the funding. As in previous years and anticipating that projects initiated next year will not all be completed in that calendar year, I have decided to allocated capital funding of over €50 million for the award of the contract for the construction of the new national forensic mental health service in Portrane, the total cost of which will be in excess of €115 million. This major capital project will include a new 120-bed hospital, two new ten-bed units for mental health intellectual disability and mental health child and adolescent services. It is a huge step in the bid to bring services into the 21st century. Overall, €74.7 million in additional funding will be spent on mental health services next year.

It is also my objective to be able to allow older people to make their own choices in as much as possible. This will require the provision of a range of services and supports to allow them to remain in their own homes and communities for as long as they can, ensuring that if and when the time comes, affordable and quality residential care will be available to them. As the Minister has pointed out, the nursing home support scheme will be funded to the tune of €940 million in 2017, which will allow waiting times for placement following approval of funding to remain at a maximum of four weeks. Overall funding for services for older people has increased to €765 million, an €82 million increase on the amount provided in last year's service plan. This funding is focused on additional provision of home care services to ensure older people can remain in their homes and facilitate the discharge of older people from acute hospitals.

Two thirds of the €40 million provided for the winter initiative 2016-17 is being spent on social care services, home care packages and transitional care beds which cater primarily for older people. The budget provides for a continuation of the €30 million provision and the provision of an additional €10 million for home care packages in 2017. Further details will be announced in the service plan when work on it has been completed in the coming weeks.

The budget matches vision with prudence and progress with sustainability. It represents stage one in the three-year agreement of the partnership Government and the collective work of all parties but most especially the work of Fine Gael and its Independent colleagues who have taken responsibility in government and are not seeking credit from the sidelines. I thank the Minister for Finance, Deputy Michael Noonan, and Minister for Public Expenditure and Reform, Deputy Paschal Donohoe, for their work on the budget which I commend to the House.

Minister of State at the Department of Health (Deputy Finian McGrath): Information on Finian McGrath Zoom on Finian McGrath I welcome the opportunity to speak about this important budget. While listening to the debate in the past few days I heard many colleagues speak about the need for vision, planning and so on. A Programme for a Partnership Government and the budget are big on vision in having a comprehensive implementation plan and providing for a huge investment in health, disability and education services. These are all practical items.

Being in government is not about having power but about using power to effect the changes, provide the opportunities and compassion we need and desire in our society. A Programme for a Partnership Government references a strong economy and a fair and compassionate society for everyone. The budget is about meeting that objective.

On disability services, I welcome the increased allocation provided in budget 2017 to address a number of priorities, as provided for in the programme for Government, including the additional funding of €31 million secured earlier this year. The allocation for disability services will increase to over €1.654 billion in 2017, compared to the €1.562 billion provided in the national service plan 2016, or an increase of €92 million.


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