Healthcare spending runs €366m over budget in first half of 2022 despite recruitment issues

Stephen Donnelly will tell Cabinet that significant energy, food and contracted services increases are driving higher spending on health

State healthcare spending ran €366 million over budget in the first half of the year, despite the inability of the Health Service Executive to fill all of the roles that it has vacant, Minister of Health Stephen Donnelly will tell the Cabinet on Tuesday.

Despite recruitment falling well short of targets, the Minister will tell fellow Ministers that the State’s spending on health during the first half of the year topped just more than €11 billion, more than 3 per cent in advance of what was budgeted for the six months.

Even though it could not fill 792 jobs, the HSE’s total number of staff grew by 2,510 full-time roles between January and June, or 1.9 per cent. The recruitment problems – despite money being allocated for posts – will continue for the rest of the year, it is believed.

Cost overruns have arisen due to significant price increases in energy and food and relating to contracts with service providers both within the HSE and with voluntary, private home care and long-term residential care service providers working for the State’s health service.


The cost overruns and the financial pressure facing the health service have been discussed with the Department of Public Expenditure and Reform and with the Government party leaders through the Cabinet subcommittee on health.

The over-budget spending during the first half of the year will put pressure on the Department of Health to supply revised end-of-year estimates on health expenditure to the Department of Public Expenditure and Reform in advance of the budget in September.

The HSE said earlier this year that it expected to recruit only half of the extra staff for which it had received funding this year as it faced recruitment difficulties.

This year’s budget provides for an increase of more than 10,000 in the State’s health service workforce, including 3,000 in acute hospitals and 7,000 in community roles.

The HSE plan published in March committed to deliver only 5,500 whole-time equivalent staff.

The health service’s recruitment targeted have been criticised by Department of Health officials in private meetings, which were subsequently leaked to the media.

HSE chief executive Paul Reid, who is stepping down from the role, attributed the difficult in meeting recruitment targets to the “challenging labour market environment”.

In recent weeks, the HSE has called on local managers to rein in spending as the health service has come under pressure to control expenditure in light of growing demands on public funds.

The Covid-19 pandemic has previously resulted in a surge in total healthcare spending in each of the last two years. Central Statistics Office data released last month found that healthcare spending topped €26.5 billion in 2020, up 11 per cent on the previous year.

Preliminary data for 2021 showed that healthcare spending reached €28.4 billion, an increase of 7 per cent. In both years, Covid-related spending amounted to more than €2 billion in each year.

Simon Carswell

Simon Carswell

Simon Carswell is News Editor of The Irish Times