Paying for health services

Sir, – Your Editorial (October 17th) states the HSE has “failed to live within its financial allocation” for the past six years. The statement is inaccurate.

I was CEO of the HSE between 2005 and 2010, during which time I was also the accounting officer responsible to government for balancing the HSE budget. The annual accounts of the HSE which are audited by the Comptroller and Auditor General, confirm that during this time the HSE operated within its budget. In 2007 the HSE overspent on some services to meet patient demand. A supplementary budget was technically required to allow movement of funds from one part of its budget to another but the overall budget allocation was not exceeded.

All other supplementary budgets during the period 2005 to 2010 were not related to budgetary control. They were, for example, provided by government to fund new initiatives that it announced during a particular year. They were never provided, to use your term, to bail out the HSE.

The HSE continued to operate within budget between 2008 and 2010 despite very significant changes in funding following the onset of the economic crisis. This was achieved through major cost reductions totalling more than €1 billion in many areas including the cost of pharmaceuticals and by centralising procurement.

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This budget control followed three decades during which overspending and the requirement for supplementary budgets to fund day-to-day services was a regular feature of the Irish health service.

Fairness requires that when discussing budgetary control at the HSE the facts as documented in the annual accounts of the HSE, and the annual reports of the Comptroller and Auditor general are accurately reported. This in turn might help to promote constructive discussion as to why such control was possible, why it did not exist prior to the HSE and why it has been lost in recent years as the HSE is deconstructed. – Yours, etc,

Prof BRENDAN DRUMM,

MD, UCD School of

Medicine & Medical

Sciences, Belfield,

Dublin 4.

Sir, – The Editorial (October 17th) referred to the Budget initiative for a thorough check to be undertaken in respect of individuals’ qualifications for medical cards.

Your Editorial said criticism of the plan has come from nursing home owners. I wish to put on record Nursing Homes Ireland (NHI), the representative organisation for private and voluntary nursing homes, has not criticised this measure.

The Editorial incorrectly stated nursing homes benefit financially in respect of the general medical card scheme. This statement is incorrect.

Responding to the Budget, NHI called on the Minister to include nursing home residents in the categories of persons exempt from the prescription charge. Fair Deal already requires residents in nursing homes to pay for a range of services not covered by the scheme. Such costs are required to be paid for from the outstanding 20 per cent of residents’ income.

Our view is the imposition of the prescription charge is incomprehensible and unfair and it is incumbent upon Minister for Health James Reilly to exempt nursing home residents from the prescription charge. – Yours, etc,

TADHG DALY,

NHI CEO,

Oak Road, Dublin 12.