Budget 2017: Health budget concessions will require change to legislation

Two headline concessions announced as part of the health budget will require legislative change before they can be introduced — provision of a medical card to the 10,000 children who qualify for the domiciliary care allowance (DCA) and reductions in prescription charges for the over 70s.

Health Minister Simon Harris told a press briefing last night the legislation in relation to medical cards was being “prepared as we speak”, and that he hoped to “get it moving before Christmas”.

He said Public Expenditure Minister Paschal Donohue had committed to implementing the prescription charge reductions from March 1. The reductions will lower the current monthly prescription charge cap from €25 to €20 and the fee-per-item from €2.50 to €2 for 330,000 medical holders aged over 70.

The briefing — at which a record five ministers spoke including Mr Harris, Disability Minister Finian McGrath, Mental Health Minister Helen McEntee, Health Promotion Minister Marcella Corcoran Kennedy, and Drugs Minister Catherine Byrne — was told the health budget for 2017 “is the single biggest investment in health ever”, even though the budget in 2008 was closer to €16bn.

A department official said “on a like-for-like basis” when you take out children (now in a separate department) and the DCA (with Social Protection) the figure did amount to the biggest health budget ever, representing an increase of €977m on the 2016 budget (€500m of this was allocated earlier in the year) for current expenditure and €40m for capital expenditure.

Mr Harris also announced that the waiting list initiative, the National Treatment Purchase Fund (NTFP), would receive €20m in 2017 to target longest waiters, rising to €50m in 2018. Last week, NTPF figures showed almost 540,000 on waiting lists. Asked if investment in the NTPF was an admission that public hospitals were not capable of doing the normal routine work, Mr Harris said “I’m afraid not”.

However, it was not his intention that the NTPF would outsource all operations to private hospitals — he said he intends to instruct the NTPF to also seek capacity for additional procedures in public hospitals.

Dr Tom Ryan, president of the Irish Hospital Consultants’ Association, said the increased NTPF funding was “at best a stop-gap measure”, and that the budget failed to address the root causes of the problems which were “inadequate acute and ICU bed capacity and insufficient operating capacity”. He said these constraints were leading to longer waiting lists and cancellation of essential surgery with increased frequency.

Asked if the Government intended to fulfill its promise to extend free GP care to under 12s, Mr Harris said it “could happen next year”, but that it depended on progress made on a new GP contract for which some money had been set aside. Asked how much money, Mr Harris said he was “not in a position to unveil” the figure in advance of negotiations.

He said the new contract would not be a “static document” that remained unchanged for 40 years, but would be a “living, breathing contract, added to as needs arise”. He said he hoped to start talks with GP representative bodies this year.

Mr Harris also announced plans to recruit 1,000 nurses and midwives including converting agency staff to permanent posts and jobs for graduate nurses some of whom he is meeting with on Thursday after which he intends to announce a plan to retain and attract nurses to work here.

However, the Irish Nurses and Midwives Organisation said converting existing agency staff would not increase overall numbers.

Asked if any money had been set aside for €700m due to hospital consultants under the 2008 consultants’ contract, Mr Harris said no money had been set aside, because the Government intended to defend the claim in the courts following advice from the Attorney General.