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Health | Health Services delivery and reform plans

To ask the Minister for Health the extent to which plans are in hand to improve the delivery of the health services and to use the experience of combatting Covid-19 to overhaul waiting lists, staff shortages, the use of theatres and associated issues with contribute to the delay in the delivery of the services; and if he will make a statement on the matter.


The Government remains strongly committed to implementing the health reform and will continue to focus on the implementation of Sláintecare. The Sláintecare Implementation Strategy & Action Plan 2021-2023 builds on the progress made to date and on the learnings from Covid-19. Many of these learnings from managing the pandemic remained embedded in our health system. These include the use of new technologies, the implementation of new care pathways, and the use of innovative approaches in patient-focused integrated care.

In relation to addressing staff shortages, especially since the COVID-19 pandemic began, the HSE is committed to ensuring sufficient staffing levels, to meet both COVID-related and long-term healthcare demands. Some of the actions and achievements in this area are the following:

  • With significant investment in recent years, the HSE have greatly expanded local and national level recruitment capacity
  • Recruitment form international markets has expanded in line with efforts to increase recruitment from our broader domestic supply for non-regulated healthcare positions.
  • Retention efforts by the HSE both nationally and locally are in place, with significant career development, progression, education, and other development opportunities being offered.
  • Improved use of recruitment technology and we reduced recruitment timelines from the average of 26 weeks in 2019 and 2020 to the current average time to recruit of 12.9 weeks.
  • As a result of these measures, we achieved the record-breaking expansion of the workforce which we now see. In 2020 and 2021 we had the biggest staff increases since the HSE was established. There are 15,428 more whole-time equivalents working in our health service compared to 2020. This includes 4,500 nurses and midwives, 2,400 health and social care professionals, and 1,600 doctors and dentists. We also added an additional 2,922 WTE this year to date.
  • Our workforce is continuing to grow at a rapid pace. This expansion will continue to the end of this year and into next year, with funding secured for an additional 6,000 Whole Time Equivalents (WTE’s) by year end, on top of the growth already achieved in 2022.

Our commitment to reduce waiting lists is shown by the development of a comprehensive approach. The 2022 Waiting List Action Plan is the first of a multi-annual approach to reducing waiting lists and waiting times in line with strategic Sláintecare targets and reforms.

  • Special funding of €350m was allocated to the HSE and NTPF for providing additional public and private healthcare activity to reduce the waiting list backlogs which were exacerbated during the COVID Pandemic.
  • In parallel with delivering immediate additional activity, this year’s Action Plan is also laying the foundations for needed multi-annual reforms. These reforms are designed to deliver sustained reductions in waiting lists into the future. They include the implementation of 37 modernised care pathways and agreeing plans to sustainably enhance capacity in all hospitals.
  • The initial focus will be on key specialties, like gynaecology, Spina Bifida/Scoliosis, and obesity/bariatrics, and others. The sum of €363m was allocated for Budget 2023, €240m of which will focus on tackling Waiting list backlogs next year.
  • Additional funding of €123m is allocated to the HSE, which will be made available on a recurring basis during 2023, to ensure that these reforms deliver sustained reductions in waiting lists.
  • These reforms will take us closer to achieve the strategic Sláintecare maximum wait time targets of 12 weeks for an inpatient procedure, 10 weeks for an outpatient appointment, 10 days for a diagnostic test.

In parallel with these achievements, health reform progress was made in primary care, community care, integrating care pathways, increasing capacity, strategic organisation, healthy-living and other areas. These results reflect the implementation of many innovative ideas combined with new ways of working which make better use of our existing infrastructural and human capital.

The eHealth Programme is a critical enabler of the Sláintecare Reform Programmes and will benefit of significant investment in eHealth capital and staffing. Key critical eHealth and technology actions that will support integration, keep people well in their community or at home, and support better acute demand management include:

• National COVID-19 Vaccination IT System

• National Waiting List Management System

• Decision support pathways

• Residential Care and Home Support Management Systems

• Video Conferencing / Remote Consultation

• Electronic Discharge System

• Health Performance and Visualisation Platform

• Integrated Information Services Supporting Recovery

• Summary and Shared Care Record

• Community Patient Management System

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