Budgeting and the health service


Sir, – In February the Minister for Public Expenditure (who has shown himself to be adept at that part of his brief) said that the enhanced contract for nurses would cost an additional €10 million to €15 million in 2019. The Minister for Health now says that the most recent estimate of the additional cost for 2019 is €39 million. This is an increase of 290 per cent on the lower range of the estimate announced by Paschal Donohoe five months ago and an increase of 160 per cent on the upper range of that estimate. One assumes that Mr Donohoe wasn’t guessing in February and that someone with access to a calculator in his department, in the Department of Health or in the HSE, gave him this estimate. The process is hardly rocket science. Someone somewhere in the behemoth that is the bureaucracy in our health service must know how many nurses we have, when the agreed increases would take effect and how many hours that nurses were budgeted to work in 2019. The calculator aided by a modicum of human intervention should do the rest.

In the real world, annual and multiannual budgets are routine. Health “budgeting” has become a very sick joke. Why should we be surprised at the annual charade of supplementary budgets for our health service if an elementary budgeting exercise carried out in February is shown to be 160 per cent to 290 per cent wrong five months later? And why should those charged with producing meaningful numbers fear any sanction when the resulting mess is always a systems issue and never the responsibility of Peter, Paul or Mary? – Yours, etc,


Rathmines, Dublin 6.