Cost-saving drives in the health service are expected to intensify in the weeks ahead as the Department of Health estimates that the HSE's financial deficit could hit €500 million by the end of the year if spending is left unchecked.
Hospitals, which were €63 million in the red after the first three months of the year, are due to submit new cost-containment plans this week.
Details of the potential €500 million overrun were given yesterday to the Dáil Public Accounts Committee where its chairman, Fianna Fáil TD John McGuinness, said the two senior officials running the health service – Department of Health secretary general Ambrose McLoughlin and HSE director general Tony O'Brien – should resign. He said both men had failed the public and the system was not fit for purpose.
Mr McGuinness accused the men of presiding over a lack of efficiency, poor spending controls, poor value for money and a failure to achieve stated goals. He said half the population were “frightened out of their lives” because of the medical card review process. Cardholders were unable to cope with medical costs and a system that was failing them.
Reviewing the performance of the health service in various areas, Mr McGuinness said the HSE was a business and if he was a shareholder he would say it was not fit for purpose.
Mr McGuinness raised concerns about a senior manager in the midwest, employed on a contract, who he said received €258,000 last year. Mr O’Brien said the post could not be filled after twice being advertised.
Minister for Health James Reilly last night rejected assertions that the health services could be viewed as a business. However he agreed with Mr McGuinness that "the HSE as a structure for delivering healthcare is not fit for purpose".
The Minister described the HSE as a failed organisation established by a Fianna Fáil-led administration and said the Government planned to abolish it.
“John McGuinness is right to point out failings in our health structures, but he is wrong to attack the leadership who are maintaining the services in such difficult circumstances and who have my confidence.”
Meanwhile Sinn Féin has urged the Government to use emergency legislation to end controversial top-up payments to senior executives in voluntary hospitals and health agencies.
Mr O’Brien said the HSE had been informed by some organisations that eight executives had legal contractual entitlements to continue receiving additional amounts over and above the official pay rate for their posts. He said the HSE had replied that if they believed there was a legal obligation to pay the additional amounts, they should “prove it”.
Mr O’Brien said that overall, 143 health executives had been receiving top-up payments. All were above grade VIII level and had an authorised salary of €80,000 or higher.Some senior staff who had been receiving additional or top-up payments had left the health service while others had agreed to cuts, he added.