The HSE has published its National Service Plan for 2019, which provides details about how it intends to spend a record budget of €16.05 billion.

This marks an increase of 5.6% (€848 million) on 2018's figure.

The HSE said that its key priorities for 2019 are to maintain 2018's activity levels, reduce costs, improve efficiency, minimise risk and promote patient safety.

"Of paramount importance is ensuring that the most pressing patient and client needs are met within the resources available," it noted.

It insisted that acute hospital services will continue to focus on reducing waiting lists, and it has promised to open 202 new beds at locations nationwide. However, it admitted that demand is still greater than supply, so patients will still experience delays.

Furthermore, it only has funding to hire an additional 2,000 employees in 2019, compared to 4,000 in 2018.

The HSE deputy director general, Dean Sullivan, said that emergency patients will be prioritised, followed by those who need urgent elective care.

"Regrettably in the context of capacity constraints, that may lead to some drop-off in elective inpatient activity for non-urgent patients, but we will seek to work with the National Treatment Purchase Fund to ensure that the overall impact on patients is kept to an absolute minimum," he commented.

Meanwhile, the plan also sets out its targets within mental health services, which will receive ‘a major investment of €55 million' in 2019. It states that the HSE aims to support people with mental health needs by improving community mental health team capacity and expanding out-of-hours responses for adults.

Within disability services, the HSE will provide 90 new emergency residential places, over 8,500 residential places and more than three million home support hours, as well as 182,506 respite overnights.

When it comes to older people, the HSE insisted that despite the many challenges it faces, the National Dementia Strategy and the National Carers' Strategy will be implemented. It added that it will provide home support through a single funding model, and provide quality and safe residential and transitional care as follows:
- 18.2 million home support hours to over 53,000 people
- 10,980 people to be supported with transitional care to leave hospital
- 4,900 long-stay and 1,850 short-stay public residential care beds.

Meanwhile, in relation to primary care, priorities for 2019 include the agreement and implementation of GP contractual changes and improvement in access to therapy services. It estimates that 1.5 million people will have medical cards, while 528,000 will have GP visit cards.

However, the National Association of General Practitioners (NAGP) insisted that the plan ‘fails to make any attempt to address the crisis currently facing patients attending their GP, with no measurable increase in resourcing for services in the community'.

"What we have here is an abundance of spin and a complete lack of substance. 2019 will be the year where waiting lists for GP appointments will reach crisis levels never seen in this country in the past, and where an ever increasing number of patients will be unable to access a GP," commented NAGP president, Dr Maitiú O Tuathail.

The Irish Nurses and Midwives Organisation (INMO) was also critical of the plan, which it said, fails to allocate extra funding ‘to provide safe staffing levels for nurses and midwives'.

"The evidence shows that extra nurses and midwives make a real difference. The Government must confirm that the necessary investment in safe nurse staffing levels will be provided in 2019, and an implementation plan agreed," commented INMO general secretary, Phil Ni Sheaghdha.

However, the HSE's plan was welcomed by the Minister for Health, Simon Harris, who pointed out that this is the fifth year in a row that the heath budget has ‘increased significantly'. However, he acknowledged that the issue of health funding ‘is a major policy challenge'.