The health service is facing a significant financial challenge in the current year, the secretary general of the Department of Health has told the Dáil Public Accounts Committee.
Jim Breslin said Minister for Health Simon Harris and Minister for Public Expenditure Paschal Donohoe had given a commitment to deal with the spending pressures without affecting patient care.
However, he said “that is going to require serious effort on the part of the HSE and department to achieve that objective”.
The Irish Times reported last week that the Health Service Executive had recorded a financial deficit of €101 million for the first two months of the year.
HSE director general John Connaghan told the committee on Thursday that it had recorded a revenue deficit last year of nearly €140 million.
Under legislation, this overrun should be considered as a first charge on the HSE’s accounts for 2018, exacerbating its financial position for this year.
Mr Breslin said the figure for the first charge was larger than the department had considered likely to materialise.
“As a priority now we are engaging to try to address that with other items. That is the detailed intensive discussions that are going on with the HSE and indeed with the Department of Public Expenditure.”
“The important thing is that we do that within the context of the HSE service plan [its agreement with the Government on how its €15 billion budget is spent] so that services are not affected.”
Mr Breslin said some of the financial slippage this year related to savings initiatives that had not yet borne fruit that were not related to patient care. He said: “We have to redouble our efforts to achieve those.”
Health service chiefs also maintained that more than €70million in income shortfalls and associated bad debts recorded last year were linked to moves by insurance companies to scale back on payout to public hospitals.
HSE chief financial officer Stephen Mulvaney said it was in talks with the Department of Health on how to deal with this issue.
Mr Breslin said there were two issues at play. One was a dispute over the date from which hospitals could begin charging private patients either from the time of admission or when a specific form was signed.
He said separately everyone with or without health insurance had an entitlement to go to a public hospital. Over the last year or so insurance companies were advising their subscribers that when they went into an emergency department they did not have to declare that they were private, he said.
“They are entitled to say that and people are entitled not to go private.”
Mr Breslin said public hospitals were experiencing a fall-off in the number of people in emergency departments who were opting to use their insurance cover.