'Modest' waiting list targets will not be met in 2016 - HSE
A target to have no adult public patient waiting more than eight months for an operation will not be met in one-third of cases next year.
And it will also not be possible to have all these waiting list patients treated within the ultimate deadline of 15 months, according to the HSE's service plan published yesterday.
It expected that the target to have no child waiting more than 20 weeks for an operation will only be met in 60pc of cases.
The admission that even these modest targets will not be fully met comes against a "health warning" issued by HSE chief Tony O'Brien.
He stressed the plan was "aspirational" in light of a €100m shortfall in funding for hospitals and other pressures.
The HSE will find itself in particular difficulty in 2016 and must strictly control spending, because of new rules which mean it can no longer receive a supplementary budget to cover over-runs at the end of the year.
The service plan sets out how the HSE will spend its €13bn budget in 2016 and how it will be carved up between different services.
Health Minister Leo Varadkar said the aim was to maintain services while an extra €99m would be allocated for new developments.
Mr O'Brien said: "In 2016 the money spent is the money provided, not the money we wish was provided."
The warning comes despite the HSE getting an €817m increase in funding.
He said it was decided to manage the €100m shortfall through greater "efficiencies" rather than cutting services.
There will be no cut in medical cards or changes in eligibility. But the anticipated fall in the cards, due to more people getting jobs and improving incomes, was reduced from 125,000 to 50,000 after it came before Cabinet on Tuesday. The number of people with GP visit cards will meanwhile rise by 50,000.
Asked what options were available if the HSE goes deeply into the red next year, Mr Varadkar said money could be diverted from one service to another.
New developments could be deferred, or other government departments with unspent funds could be approached. It could also be carried over as a first charge on the 2017 Budget.
The plan was criticised by doctors' groups and Fianna Fáil's health spokesman Billy Kelleher who said it made "grim reading" for the health service.
But it does allow for more direct access by GPs to ultrasound for patients who need to be screened for conditions such as ovarian cancer.
There will be an additional €10m for the extension of BreastCheck to older women and the expansion of BowelScreen.
The budget for the Fair Deal scheme has been increased to €940m to support 23,450 people in nursing homes. The aim is to keep waiting times to fewer than four weeks. There is also a provision for the extension of free GP care for the under-12s at the end of the year, subject to talks with the IMO.
All maternity units will have a director of midwifery and pregnant women will get better access to scans.
More funding is to go towards counselling in mental health services and specialist services in post-natal depression will be improved.
A mental health programme aimed at ADHD in adults and children will be set up.
Following negotiations on price, it is hoped to be able to give children vaccines against meningitis B and rotavirus.
Commenting on the ongoing pressures on the health service to make expensive, newly-licensed drugs available, the minister said a Europe-wide approach was needed.
Drug companies currently set prices high for small countries and give discounts to larger countries. This amounted to "greed incorporated" by some companies, he said.