Health Service Executive annual report and financial statements 2011.

Page 2: Since 2005, there has been a 52% rise in people entering drug treatment and a 42% increase in numbers treated for alcohol problems. See page 68 & 69 of report for information around substance misuse. Finance The HSE fully expended its vote of €13.588 billion in 2011 in what was a very challenging year for the health services. This included grants to outside agencies governed by Section 38 and 39 of the Health Act, 2004, to the value of €3.45 billion. Just under €318 million capital monies were expended in 2011. Over the last two years, health expenditure in Ireland has reduced by €1.75 billion. This has largely been achieved through a combination of procurement efficiencies, successive drug price reductions, increased income from private patients and managing staff costs. Stringent cost containment plans operated throughout 2011 in all services as well as approximately €360 million in expenditure reductions in the Primary Care Reimbursement Services (PCRS). In recognition of some of the service and demographic pressures, additional funding of €56 million was made available by Government in 2011 to progress specific initiatives in the areas of suicide prevention, disability services, children and family services, cancer services and services for older people. Human Resources Employment levels decreased by 3,580 staff (3.3%) in 2011 compared to end 2010. This is in line with Government policy to reduce staffing levels in the public sector. At the end of 2011 there were 104,392 whole time equivalents employed in the health services. These staff reductions are significant and have required, and continue to require, staff to be flexible; both to increase overall productivity and reduce costs. Performance Activity Planned activity levels were delivered and performance improved across many areas in 2011, despite the challenges. During 2011: - Over 75% of the population or over 3.4 million people availed of services through 425 Primary Care Teams - Almost 950,000 contacts were made with GP out of hour services - Over 1.69 million people have medical cards or 37% of the total population. This is the highest number of people ever recorded in receipt of a medical card. Over 125,000 people or 2.7% of the population were covered by a GP Visit Card. - Over 77.9 million transactions were made through the Primary Care Reimbursement Service (PCRS). - 728,453 treatments were provided under the Community Ophthalmic Services scheme, a 4.5% increase on the previous year. - Uptake rates for the first year of the HPV vaccination were 82% and exceeded the target we set of 80%. - Over 1.39 million people received inpatient or day case treatment, a 5% increase over that provided in 2010. 69,000 more patients received day case treatment in 2011, an increase of 9% over 2010. This is in line with our ongoing policy of moving from inpatient to day case treatment where possible. - 49% of all elective inpatient procedures were conducted on day of admission. - 78% of all inpatient stays and 84% of all day case treatments were public patients. - There were over 1.09 million attendances at Emergency Departments. - Over 3.5 million bed days were used with an average length of stay of 6 days. - 73,098 babies were born in our hospitals of which 27% were delivered by caesarean section. - 37,350 women attended symptomatic breast services. Of these, 99% of referrals deemed urgent were seen within 2 weeks and 97% of non urgent referrals were seen within 12 weeks. - There has been a 16% increase in the number of children in care since 2007 with 6,160 in care at the end of 2011. Of these, 7% were in residential care with over 90% in foster care. - 24% more disability assessments for children under 5 years were completed than in 2010. - Over 11.09 million home help hours were provided to 50,986 clients. - 10,968 people received a home care package, an increase of 10% against 2010. - 22,327 people were supported under the Nursing Homes Support Scheme, 629 more than in 2010. - There were 61 Child and Adolescent Community Mental Health Teams in place, an additional six teams since 2010. Referrals to child and adolescent mental health services increased by 10% in 2011. Demand for health services continues to grow as a result of population increases, economic changes and medical advancements. The HSE faced immense challenges in 2011 to operate within its funding and employment constraints in a way that minimised the impact on both the quality and range of services provided to patients and clients. In order to meet growing demand within the context of a reducing resource, services are being maximised through fast tracking new, innovative and more efficient ways of doing business. Implementation of the National Clinical Programmes, being implemented by clinically led multidisciplinary teams across the country, is driving the re-engineering of traditional models of care. During 2011 Government announced its reform measures for the health services. The HSE continues to work with Government and the Department of Health in laying the foundations for this major health reform programme