The HSE National Service Plan for 2022 has been published with a funding allocation of €20.7 billion for the health system.

Minister for Health Stephen Donnelly said it aims to cut waiting lists, build hospital and other service capacity and progress Sláintecare.

He said it was the largest financial allocation to health.

HSE Chief Executive Paul Reid said there was a renewed hope that Ireland was moving towards a more normal environment, in which waiting lists can be tackled and the HSE can build on innovations during the pandemic.

The 171-page plan sets out the spending for each area and various targets.

Mr Reid said that because very little is certain about the future epidemiology of Covid-19, the HSE has decided to maintain the current testing and contact tracing capability for the foreseeable future.

The plan says that the target this year is that 98% of adults and children should be waiting less than 12 months for a planned procedure.

Also, 98% of people should be waiting less than 18 months for first access to an outpatient department clinic.

It says that 70% of people attending emergency departments should be discharged or admitted within six hours of registration.

The plan says that if there was any upside to the cyber attack it was the renewed focus on information technology.

Hiring staff 'a significant challenge'

It warns that one of the key risks for the HSE in the successful delivery of services across the entire healthcare system is its capacity to hire staff with the skills that are needed.

"Attracting additional staff to provide care and progress key reforms is a significant challenge. Very often we find ourselves hiring from one part of the organisation in order to staff another part," Mr Reid states in the plan.

The plan says that the minimum target for staffing in the HSE is to have 137,414 whole-time equivalent staff by the end of this year. In September last year, there were 130,636 staff.

The plan says that during 2022, the HSE and Department of Health will design and develop the specification for the planned new Regional Health Areas.

The HSE says it is now recognised that persistent and prolonged symptoms can occur after acute Covid-19 infection. As a novel condition, services for those with Long Covid-19 symptoms are in the early stages of establishment.

During 2022, the HSE says it will work with patients to put in place an appropriate Long Covid-19 service.

The plan says the ongoing pandemic will continue to bring uncertainty and complexity to the planning and delivery of services this year.

"It follows that it is not practical to provide the usual level of assurance around the extent and overall affordability of likely 2022 activity, particularly in respect of acute hospital services," the plan states.

According to the plan, by the end of 2021 it was expected that 849 extra hospital beds would be open.

It is expected to have 1,000 of these beds opened by the end of the first quarter of this year, with the remaining 146 beds, which are dependent on capital works, to be open later in the year.

The number of critical care beds is to be brought up to 340 this year.

Demand for cancer services is expected to grow this year by 10%-12%.


The health service has an insatiable appetite for funding. The €20 billion plus in the allocation this year is a record level.

Yet, the overall impact on waiting lists will not be clear until the end of the year.

The targets set by the 2022 National Service Plan published today plan are simply that, targets.

Some targets are 'stretch' targets, which can be seen as another term for ambitious.

There is nothing wrong with being ambitious, however, as with any plan, not all targets may be reached and so the document needs to be viewed in that light.

There is optimism in the HSE however that as the impact of Covid-19 wanes, hopefully, the service can move towards a more normal environment.

The HSE is also planning to develop a service for people with Long Covid, a new condition.

The other notable warning by Paul Reid is about staffing.

A lot will depend on the HSE's ability to hire the staff it needs in the right areas.

Overall, the HSE is hoping that as the effects of Covid-19 recede and it recovers from the cyber attack with a better IT system, these issues will not be there to knock its plans off course this year.


Consultants say targets are not realistic

The Irish Hospital Consultants Association has said that the targets in the plan are unrealistic

It said: "This latest plan in no way adequately addresses these key deficits, that are the root cause of there being almost 1 million people waiting for essential care in this country.

"The last time there were no patients waiting longer than 12 months for hospital treatment was in December 2013.

"To consider including such a target today, after what has been the most challenging two years for our health service and at a time where there remains over 700 vacant Consultant posts, completely undermines the credibility of this plan."

Mr Reid has said that many of the issues to be solved in the health service, will not be solved in one year.

In an online briefing, he said the year-on-year increase in funding, excluding Covid-19 funding, is €1 billion.

Of this, €700m is to maintain existing levels of service and €300m for new developments.

Mr Reid said Ireland has a growing and ageing population and the percentage of people over 65 has increased by 18%. He said this puts increased pressure on the health service.

Mr Reid also said more proposals will be brought to Cabinet to strengthen the HSE's cyber security.

Paul Reid

He said the new plan will mean increased capacity in community services, especially for older people. More services will be provided in primary care. Hospitals will have increased investment and in particular waiting list targets.

Mr Reid said the HSE was still living with the risks from Covid-19.

He said it was unclear at this point if there would be an annual Covid-19 booster vaccination or a targeted one for vulnerable people.

He said the HSE will go to Government in about four weeks with recommendations on the Covid-19 test and trace system.

Meanwhile, the Health Protection Surveillance Centre has been notified of 3,300 PCR-confirmed Covid-19 cases.

4,771 people have registered a positive antigen test through the HSE portal.

There are 616 Covid-19 patients in hospital, 48 of whom are being treated in intensive care.

In Northern Ireland, five more people have died with Covid-19.

There have been 2,567 further confirmed cases of the virus, while 473 Covid-19 patients were being treated in hospital, five of whom were in ICU.