Budget sets spending limit just over €22bn

Funding for accelerated roll out of national strategies and models of care promised for 2021

A limit on health spending next year has been set at just above €22 billion in Budget 2021 announced today (Tuesday, October 13), allowing €5 million for Brexit-related measures and €1,881m for Covid-19 related expenditure.

The ceiling on core spending is set at €20,231bn in 2021 excluding Brexit and Covid-19 eventualities.

New spending measures promised for 2021 for increased capacity in the health services, funded by €467m, include an expansion in the number of acute beds by 1,146 and sub-acute beds by 135 by the end of next year.

Permanent adult critical care beds are to be increased to 321 by the end of 2021, an increase of 66 more than funded 2020 levels; funding is provided for 1,250 community beds next year which includes an excess of 600 new rehabilitation beds.

Another spending measure in Budget 2021 promises accelerated implementation of 15 national strategies, models of care and expert reviews or services through funding of €147m.

This finance is earmarked to accelerate the implementation of the National Cancer Strategy 2017-2026; National Maternity Strategy 2016 -2026; A Trauma System for Ireland; National Ambulance Service Strategic Plan; Model of Care for Ambulatory Gynaecology; Model of Care for Infertility; Paediatric services including the new children’s hospital; organ donation and transplant initiatives; the Women’s Health Taskforce; Palliative Care Strategy; National Dementia Strategy; Covid-19 Nursing Homes Expert Panel Report and other social care strategies.

Delivering enhanced community and social care services receives €425m for 2021 and aims to make care more accessible in the community. General practitioner (GP) access to diagnostics has been provided under this measure to streamline access for GPs to approximately 136,000 diagnostic tests in 2021.

An additional 5 million hours of home support are to be provided in 2021, underpinned by the rollout of the InterRai Single Assessment Tool, to ensure a standardised assessment process is in place.

Finance totalling €318m has been voted for “improving access to care”, of which €210m is being provided for a new ‘Access to Care’ Fund to improve access to care significantly impacted by the Covid-19 pandemic.

The Department of Health is to work with the Health Service Executive (HSE) and National Treatment Purchase Fund (NTPF) to develop an Action Plan for 2021 to improve access to care, to be finalised in parallel with the HSE National Service Plan 2021.

Another €30m has been set aside for the NTPF bringing the Fund’s total funding to €130m.

Under the €318m “access to care” heading, funding has been committed for alternative care pathways and supporting the restart of activity to facilitate improved access to services within the Covid-19 environment, including investment in new processes, care pathways and infrastructure.

Funding has also been provided under the “improving access to care” measure to create greater resilience in the cancer services pathway to minimise delayed diagnosis and protect against future Covid-19 outbreaks.

Under the spending measures for mental health services outlined for Budget 2021, funding is committed to progress “Sharing the Vision” and to address ongoing needs arising from the impact of Covid-19 in the mental health services, through service enhancements, technological developments and new service developments.

A total of €12m goes to expand the public health workforce; an investment of €58m is earmarked for eHealth and the introduction of new drugs has funding of €50m for 2021.

The Expenditure document stated that the Health Budget had been compiled on the basis that a vaccine for Covid-19 would not be available in 2021.

In this regard, funding of €1.3bn was allocated to ensure that personal protective equipment (PPE) continued to be available for employees across all areas of the health system and to implement a comprehensive nationwide Test and Trace system.

A further €404m is promised for the continuation of ongoing Covid-19 supports in 2021 including planning for surge-related acute capacity, staff health and wellbeing, communications, infection prevention and control, accommodation, and isolation facilities.

Capital spending is set at €1.01bn which includes €880m “core” spending and €130m in Covid-19 capital spending.

The Budget commits to €3.8bn being spent on supporting existing services across a range of departments, in particular the Department of Health.


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