An extra €848 million has been provided to fund the health service next year, bringing the total Health Service Executive budget to a record €16.05 billion.
Extra funding should be good news for patients, but the 5.6 per cent increase will not automatically translate in a major boost to services for those visiting the State’s hospitals.
Pay rises and pension payments, for example, will eat up close to €400 million of the sum. A further €114 million is being earmarked to meet the “first charge” – the deduction of part of this year’s overrun from next year’s budget, which is stipulated in legislation.
In fact, when all the cost pressures are set out against the additional funding, the HSE has calculated that it could end up with a €50 million shortfall.
A draft of the service plan given to Ministers last Friday caused controversy in parts of Government after The Irish Times revealed that those proposals would have seen reductions in the number of elective, non-urgent patients treated in hospitals. There was also the prospect of growing waiting lists for people seeking to access the Fair Deal nursing home scheme, which provides financial support to those in need of long-term nursing home care.
This unhappiness led to a revision of the numbers and haggling between Ministers, Department of Health officials and HSE management, which went on until just hours before the service plan was published on Thursday afternoon.
Waiting lists
Despite the late rush, Minister for Health Simon Harris struck an optimistic note about what was to come. The plan would see the numbers on hospital waiting lists drop by 10,000 while more than 200 additional beds would be opened, he said.
However, the number of elective patients treated will increase only when additional funding, provided through the National Treatment Purchase Fund, is added into the mix.
The Minister did not deny there were last-minute revisions to the plan. He said there was a collective concern to get the Fair Deal funding issue “right” and to ensure waiting lists for the scheme did not escalate.
The HSE had sought just shy of €1 billion for the Fair Deal scheme. It secured €961 million. The service plan says “every effort” will be made to maintain the Government’s four-week maximum waiting time.
However, in its assessment of the plan, in light of available funding, the HSE did not seek to hide the challenges that await it in the year ahead.
HSE deputy director-general Dean Sullivan said the organisation had no contingency funding to deal with unforeseen events such as storms.
He said there was a “degree of restriction” on the scale and pace of the health service transformation programme that could be delivered, and that it could be challenging to respond to new technologies and drugs becoming available.
However, perhaps more worrying in the longer term was the revelation that the budget for next year had been pieced together using money provided on a once-off basis to pay for ongoing continuing services.
Even in the event of the health service staying within its allocated budget next year, trouble is being stored up for the times ahead.