Concern over lack of detail in HSE spending

THE DEPARTMENT of Finance has expressed serious concern at the lack of detail provided by the Health Service Executive (HSE) …

THE DEPARTMENT of Finance has expressed serious concern at the lack of detail provided by the Health Service Executive (HSE) in its spending plan for this year.

The department has written to the HSE seeking a breakdown of how much it plans to spend on each programme of care this year as well as details of the numbers it employs in each area.

In a letter to the Department of Health on March 4th last, the department said the HSE's 2008 service plan "also fails to provide full details of the proposed €300 million value for money measures" planned by the HSE for 2008. It said "such information is critical to the proper management of HSE expenditure".

It has sought details from the HSE of how these savings will be made on a month by month basis.

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The letter also outlines how the Department of Finance plans to exert much tighter control over HSE spending this year after it overspent by millions last year.

In its letter, the department is critical of overspending by the HSE saying: "Despite the making available of unprecedented levels of resources in recent years, the HSE has only managed to remain within overall budget through a combination of diverting development and capital monies away from key Government priorities intended to address the needs of an ageing and expanding population, the reclassification of minor capital from current to capital and the use of savings from the Nursing Home Repayment Scheme".

The new controls being put in place means the HSE will have to attend monthly meetings to update both departments on its financial position.

It will also have to meet with both departments every second month to report on how it is controlling employment numbers.

The HSE has also been asked to review its arrangements for the collection of charges "and identify the steps necessary to improve the timeliness of their collection".

Furthermore, it has been requested to made available to both departments all reports or studies that have implications for exchequer expenditure as soon as they are considered by the HSE board.

The Department of Finance has also asked the HSE for an explanation of how the number of grade 8 management posts in the organisation increased by 153 in the period up to September 30th last year when approval for only 50 such posts was sought from both departments.

Meanwhile, the Department of Finance has set a new employment ceiling for the HSE this year of 112,560 full-time staff, which it says will allow for the filling of 1,050 additional development posts. The new posts will include 100 in elderly people services, 90 in cancer services, 710 in the disability sector, 50 in palliative care and 100 in population health.

The documentation from the Department of Finance came to light when health service unions met the HSE in Dublin yesterday in relation to its breach of Towards 2016 when it imposed a ban on recruitment last year without consulting staff.

While it had been expected the HSE would outline cost-cutting plans at the meeting Dave Hughes, deputy general secretary of the Irish Nurses' Organisation, said the unions refused to engage in any dialogue on cutbacks until the HSE demonstrate good faith by honouring all existing agreements.

"There are, at this point, over 20 agreements freely entered into by HSE management which have not been implemented. Among these are Labour Court recommendations and legally binding determinations. Many relate to understaffing which is having an impact on the delivery on quality patient care," he said.

The next meeting is scheduled for April 7th.