Opening Statement by HSE Chief Executive Officer, Prof. Brendan Drumm at today’s meeting of the Oireachtas Joint Committee on Health and Children

June 18, 2008


Chairperson and Members, thank you for the invitation to attend this meeting today. I would like to begin by congratulating you, Deputy O Fearghaíl on your appointment as Chairperson and to assure you and the Members of our continued co-operation with the Committee.  

I intend here to give you a brief update on the progress we are making since our last meeting. I will also deal with a number of specific issues, some of which you have indicated you wish to raise with us. Together with the senior colleagues accompanying me today, we will be happy to discuss them further or indeed any other items you may wish to raise.

The HSE is now providing more high quality services to more people than ever before and this is borne out in our Annual Report for 2007, launched yesterday. Record numbers of health care professionals are delivering these services with a budget provided by the public that is at an all time high. This enables us to provide many excellent services and deliver on our mission - to enable people live healthier and more fulfilled lives. I would like to take a few moments to illustrate this point.

People in Ireland are healthier than they have ever been and are living longer than at any time in the history of the State.

Our life expectancy has stretched by around four years since 1996; 4.3 years for males and 3.2 years for females.

Independent research shows that satisfaction levels with people who use our services are very high - in the 80% to 90% range.

Almost 1.3 million people – 30% of the population have medical cards and can avail of free medicines and GP care. We estimate that this year we will spend €2.78billion or the equivalent of €7.6 million per day on demand led schemes such as the medical card scheme.

Ninety per cent of people now have access to GP services on a 24 hour basis – last year the out of hours services took more than 800,000 calls and 30,000 x-rays and ultrasounds were provided through a direct GP access scheme.

An additional 850 long stay beds were made available for older people who were not well enough to return home after receiving hospital care - more than 20,000 older people now avail of these types of facilities. 

Between now and 2013 we are planning to develop 3000 community-based long stay beds (new and replacement) for elderly people involving an investment of around €600 million.

In the community, Home Help Services, mainly for older people, are up 6%, with over 4 million hours delivered already in 2008.

The numbers who are getting Home Care Packages which include public health nursing, physiotherapy, occupational therapy and attendance at a day care centre is ahead by 29% on the same time last year.

Primary Care Teams, where people will get 80-90% of their care are taking hold – 97 are in advanced development.  The HSE remains fully committed to having half of the targeted 530 Primary Care Teams in place by the end of 2009 and we welcome the commitment of primary care professionals to this goal.

The HSE has received 450 proposals from the private sector to provide facilities for Primary Care Teams in 131 locations and negotiations are well underway. 

In addition, the HSE will shortly be advertising for proposals to develop primary centres in more locations. These are in addition to the 70 primary care centres already developed and being developed by the HSE.

Central to the Primary Care Team (PCT) approach is the assignment of existing community based staff such as therapists, public health nurses, general nurses and home care workers along with General Practitioners to specific teams. 

Approximately 630 HSE allied health professionals have been assigned to PCTs.  In addition there are over 500 GPs participating in PCTs in various stages of development together with a number of practice nurses and other GP practice resources.  

222 new posts have been filled and allocated to Primary Care Team around the country and a further 77 are in the process of being filled. Another 300 posts have been allocated and it is envisaged that recruitment of these will start at the end of the year.

In hospital services, the latest data is showing that the average length of stays (ALOS) is reducing in many hospitals. For example, preliminary data shows that at the Mater hospital the average length of stays has reduced from 12.5 days in 2007 to 9 days now.

The shift towards treating more patients on a day case basis continues - almost half of all hospital patients are now treated on a day case basis. Day Case attendances are up by 10% for the first 4 months of this year when compared to the same period last year.

We saw over 1 million people in out patient clinics in the first 4 months of this year an increase of 9.4% on the same time last year and this is an area we are very focused on for 2008.

We saw almost 400,000 people in Emergency Departments in the first 4 months of this year, up approximately 4.6% from this time last year.

While it may seem that I am over stressing these statistics, they are important to illustrate that a great many parts of the health services are serving the community well.

Palliative Care

I would now like to turn briefly to palliative care. Significant ongoing resources are provided by the HSE  for the delivery of palliative care services by a range of statutory and voluntary palliative care providers across the country on an annual basis, for example in 2007 a total of €75m was spent on palliative care services. 

This investment in palliative care services allows for the provision of a wide range of supports for palliative care patients including specialist inpatient beds, home care teams, palliative supports in acute hospitals and day care services.

On average 330 patients are treated per month in specialist inpatient units; some 2,500 patients access homes care services; 80 patients access intermediate care in community hospitals and some 260 patients benefit from the provision of day care services.

This year, the HSE Service Plan commits to delivering a further €3m extra monies in additional developments.  

Currently we are completing a multi annual five year plan for the development of palliative care services, with significant involvement from the voluntary sector.  This plan will provide the framework for revenue and capital investment, in order to ensure equitable provision of services across all parts of the country. 
The decision to undertake this plan was based on discussions between the Minister for Health & Children, the HSE and bodies such as the Irish Hospice Foundation, the Irish Cancer Society and the Irish Association of Palliative Care.

It is intended that the plan will be complete by the end of June and will provide a very sound planning framework for the sourcing and investment of additional resources.  Palliative care is a key priority for the HSE and will continue to be so.

Consultants Contract

The Independent Chairman of Contract negotiations – Mark Connaughton SC – has begun to draft the final version of the contract documentation.

Once Mr Connaughton completes his work, Consultants will be offered the new contract. They will have until 31st August to accept the Contract.

In the past few weeks, the Contract Implementation Team has progressed 129 Consultant posts to advertisement under the Consultant Contract 2008.   It is intended to commence interviews for a number of these posts in August, with the remainder interviews to commence in September.


I would now like to turn briefly to the issue of our employment strategy.

There is a perception taking hold that the HSE is operating a recruitment embargo. This is not the case. There is no recruitment embargo in operation within the HSE. 

In September 2007, a recruitment pause was introduced but a derogation process was also put in place to allow critical posts to be filled. 

Accordingly, recruitment activity and the filling of vacant posts continued right throughout the latter part of 2007.  Some 900 derogation requests were processed during that time.  

The recruitment pause was lifted before the end of 2007.

In January this year, we established in the four HSE areas, Employment Groups which examine requests to fill vacancies. Our priority within this process is frontline posts.

Since January 3,584 posts had been approved and are being filled. This represents almost 90% of all approval requests and of these posts, 80% represent medical/dental, nursing, health and social care professionals and other patient and client care staff.

Chairperson and Members I am convinced that we are making good progress in reforming our health services and our just published annual report for 2007 is testament to this.

But completely reforming Ireland’s public health service into a modern service where 80-90% of care is provided outside acute hospitals has to happen progressively, it can’t happen all at once. It will need a commitment to change not just from those who work in public health, but also from those who are in a position to influence change such as the social partners, public representatives, media and advocacy groups.

As a community we all have a role to play in the future of our public health service. Whether this role is as a user of services or provider of services, we must at all times ensure that quality and safety are never traded for convenience and consensus.

Finally I would like to thank you for your attention and with my colleagues we will do our best to answer your questions and provide you with as much information as we can either here this morning or if we do not have the information to hand by following up with you as soon as practicable after the meeting.

This concludes my opening statement.


Last updated on: 18 / 06 / 2008