St Vincent’s University Hospital, Dublin, has said it has not signed a service agreement with the HSE for this year as the budget it has been offered does not meet service requirements.
Representatives of the hospital are expected to tell an Oireachtas committee on Thursday it experienced a funding shortfall of €26 million across 2023 and 2024, but recorded a break-even position last year.
Meanwhile, the Mater hospital in Dublin is to tell the committee it has an accumulated financial deficit of almost €50 million.
The Mater said that in the early part of last year it was facing a potential deficit of more than €33 million based on its original allocation.
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It said in a briefing document for the committee that adding to the accumulated deficit “would have raised the potential for director exposure under company law, particularly in relation to solvency and trading obligations”.
The Mater suggested if it were not for a “risk-sharing” deal reached with the HSE in April last year, which allowed it to reach a break-even position, essential patient services would have had to have been curtailed or suspended.
“The HSE annual service arrangement process with its single-year focus is in need of modification. Negotiations frequently begin from the previous year’s baseline, despite clear growth in demand and activity. Agreements are often not concluded until late in the financial year, which undermines effective financial planning, workforce recruitment and service development,” it said.
“In practical terms, this process does not support the operation of a big national hospital. We believe there is a strong case for moving to a multiannual, activity-based funding model, linked not only to volume of activity but also to patient complexity, acuity, age profile and national referral responsibilities.”
Tallaght Hospital is expected to tell the Dáil Public Accounts Committee on Thursday that it has a historic deficit of €25 million. It said it cost €438 million to run the facility last year and the projected out-turn for this year would be €471 million.
It said in a briefing document that under the 2026 service agreement process with the HSE, any financial overrun recorded would form part of the hospital’s opening position for next year if it was not addressed.
“The hospital carries substantial operational, governance and clinical risks with ongoing difficulties with signing the service level agreement,” it said. “In the absence of an appropriate budget allocation, curtailment of services in order to align activity with the allocated budget would have a significant and detrimental impact on patient access and safety, particularly in the context of growing demand.”
St Vincent’s representatives are expected to tell the committee that it understands the pressures the HSE regions are under and that all have the same objective to provide excellent care to the patients who need it in an efficient and impactful way.
“We accept that there are limitations to funding, but the increased demand we, and the whole sector is seeing, is driven by the growing and ageing population. This will not abate and we need to work together to ensure a health sector that is resourced to meet that demand,” it is to say.
