HSE faces new challenges despite record funding for next year

The Government has provided an additional €50 million to provide the health service with its largest-ever budget next year. However controversial employment restrictions will continue, some public nursing home beds face closure and several hundred millions in savings will be needed to deal with financial challenges.

The additional money, which is on top of the extra €1 billion allocated in the budget, will be used for services for older people and those with disabilities as well as to relieve hospital overcrowding, on homelessness projects and as seed funding for the first State-funded IVF (fertility treatment) scheme.

The HSE will now receive more than €17 billion next year including the additional €50 million approved by the Cabinet as part of the revised financial estimates.

However, in its service plan for next year, published on Tuesday, the HSE signalled it would need an additional €420 million to address demographic, technological and other pressures and to tackle unmet need.

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Government sources said Minister for Finance Paschal Donohoe had, as part of the revised estimates process, turned down requests from the health sector for even more funding.

Relieve pressure

It was also suggested by well-placed sources that the Department of Housing was seeking more money for Irish Water.

Extra funding for RTÉ, which was announced last week, is included in the revised estimates for the Department of Social Protection.

Among the Ministers who received increased funding in their sectors was Minister of State for Disability Issues Finian McGrath, who received an extra €8 million.

The HSE said it was happy with its funding, part of which will be used to see a shift in emphasis towards community services to relieve pressure on hospitals.

The HSE plan indicates that as part of measures to deliver a 4 - 5 per cent cost reduction next year, some beds in public long-term care facilities may have to close “preferably temporarily”. It also says efficient savings of about 1 per cent will be applied to budgets in service areas and a minimum of about 1.3 per cent in corporate-type areas.

It suggests the HSE may have a challenge in dealing with pay restoration for staff in grant-aided bodies (known as section 39 organisations) outside of an initial group of 50 such organisations.

Hospitals currently dealing with severe overcrowding are also facing a potential strike by consultants and non-consultant doctors early in the new year following a ballot by members of the Irish Medical Organisation.

The doctors are seeking a reversal of pay cuts for medical specialists appointed after 2012.

Restrictions

The Government is expected this week to announce that new “Sláintecare” contracts for hospital consultants will be introduced early next year. These would have pre-2012 salary levels. However in return such consultants would only be permitted to treat public patients.

The confirmation that employment restrictions introduced last year are to remain is also expected to anger trade unions representing nurses and other groups which have repeatedly called for them to be withdrawn.

The Government has insisted there is no overall recruitment embargo and HSE chief executive Paul Reid said despite the restrictions, the health service had taken on about 2,500 additional personnel over the last year.

The Government's official direction to the HSE on drawing up its service plan, which also emerged on Tuesday, shows that the Department of Health sought the employment restrictions to remain.

“The progress made during 2019 in aligning workforce to funding is recognised and the controls should continue through to end 2020.”