The Government has provided more than €600 million in additional funding for the health service next year, bringing the total budget to more than €14.5 billion. However, even before the start of 2018, the Health Service Executive is warning of potential financial difficulties.
The health authority has forecast that it will face a €346 million “financial challenge” in its operational areas next year.
To mitigate this the HSE is putting in place what it described as a "value improvement programme".
The service plan – which is the HSE’s agreement with the Government on how the €14.5 billion budget will be spent next year – is somewhat vague on the exact measures that will be taken to deal with this “ financial challenge”.
It says the value improvement programme measures should be realistic and achievable and not impact adversely on patient services.
However, in essence the value improvement programme sounds suspiciously like the savings targets that were set out in service plans in previous years to plug financial gaps – many of which never materialised, forcing the Government to inject supplementary funding into the system towards the end of the year.
Deep within the service plan there are also other warnings.
The HSE says it has no capacity to deal with any pay pressures other than increases set out in the new public service accord.
"In the event that additional pressures emerge, for example, via the industrial relations machinery of the State, regulatory processes, Government decisions or the courts, the HSE will need to engage with the Department of Health as to how to proceed."
One area where this may become very relevant is the group of organisations known as section 39 bodies. These receive grant aid from the HSE to provide a range of health and social services, but are not technically in the public service. Staff in section 39 organisations are currently balloting for strike action. The HSE also warns its capacity to respond to the emergence of new drugs is limited – another highly sensitive area about which more will undoubtedly be heard.
The Opposition was quick to criticise elements of the plan on Wednesday and is also likely to press the Government in the weeks ahead on the exact status of the 1,800 additional full-time staff promised in the budget last October.