Hospitals are facing budget problems, but it's too soon to panic, writes Padraig O'Morain
It is beginning to feel like the morning after optimism. After years of hefty funding increases for the health services, we have some health boards announcing measures, such as cancellation of planned surgery, to deal with budgetary constraints.
We also have five of the major Dublin teaching hospitals estimating that what they will end up getting for this year could be €50 million less than they need.
The high cost of drug therapy for illnesses such as cancer and the financial impact of the winter vomiting virus are among the factors which pushed some hospitals and health boards into overspending from the start of the year.
The vomiting virus increased costs in several ways. The Southern Health Board found its income from private patients wiped out because the 20 per cent of beds designated as private in public hospitals were occupied by the victims of the virus, who had to be kept isolated.
The Midland Health Board had to pay agency nurses while its staff were out sick with the virus. Moreover, it increased day treatment to compensate for the loss of inpatient services due to the virus - but that meant paying overtime to the nurses and hospital doctors who were still on their feet. And, while hospitals are more efficient and treating more patients, that in turn means they are spending more money on treatment.
How bad is all this? It is an unhappy trend but not yet a crisis. Compare this with the cuts out of which the health system began to emerge in the mid-1990s. A decade of cutting (largely by Fine Gael/Labour governments, opposed by Fianna Fáil) was followed by deep, across-the-board cuts (by a Fianna Fáil government, opposed by Fine Gael/Labour).
It was a terrible time, and the contrast with the present could not be sharper. We have emerged from an era of unprecedented increases in spending on health, and while future years might see the size of increases curtailed, there is no sign that deep cuts are on the way.What this threatens, though, is a situation in which there will be little or no improvement in health services over the next few years.
And that constitutes a real challenge for a Minister for Health and Children of whom there are high expectations.