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FactCheck: Does this year's Budget include the biggest ever investment in health?

Questions surrounded one of the government’s biggest talking points from the Budget. FactCheck gets to the truth.

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Updated: 5 November

ONE OF THE government’s biggest talking points in the aftermath of last month’s Budget announcement was the claim that they had just made the biggest investment in health in Irish history.

Public Expenditure Minister Paschal Donohoe said it during his Dáil speech, Health Minister Simon Harris said it during a post-Budget press conference, and Taoiseach Enda Kenny repeated the claim in the Dáil later on.

But is it true?

(Send your FactCheck requests to factcheck@thejournal.ie, tweet @TJ_FactCheck, or send us a DM).

Claim: Budget 2017 includes the biggest ever investment in health
Verdict: TRUE

What was said:

TheJournal.ie / YouTube

You can see excerpts of government ministers reiterating the claim, in the video above.

In his Dáil speech on Budget Day, Paschal Donohoe described the health budget as “the highest ever level of health funding in the history of our country”.

At a press conference that evening, Simon Harris said:

This is the single biggest exchequer investment in health, ever, when you take it on a like-for-like basis.

And later in the month, Taoiseach Enda Kenny told the Dáil the €14.6 billion in gross spending in the budget was the “highest ever allocated to the health portfolio”.

At the post-Budget press conference, however, Sunday Business Post health correspondent Susan Mitchell questioned the claim, and correctly pointed out that gross expenditure was actually higher in 2008 and 2009.

THE FACTS

11102016-cabinet-meetings-4 Health Minister Simon Harris outside government buildings on Budget Day Sam Boal / RollingNews.ie Sam Boal / RollingNews.ie / RollingNews.ie

In response to our request for evidence, the Department of Health sent us a detailed breakdown of health spending from 2008 to the present day.

It should also be noted that, between the HSE and the Department of Health, it took more than three weeks for the relevant figures to be provided and clarified.

This issue gets a bit complicated, so we’re going to try to keep it as simple as possible, but for details, you can download a spreadsheet with all the data, below.

Annual government spending is, in short, categorised into “groups”. In the Department of Public Expenditure’s Databank, health spending is (as you may have guessed) included in the “Health” group.

This is total health group spending between 1994 and 2017. Obviously, the 2017 figures are not for spending, but rather spending allocation, taken from this Budget document.

For a full-size version of this chart, click here For a full-size version of this chart, click here

You can see the problem.

Gross spending in the health group was higher between 2007 and 2010, than the allocation for 2017.

Exclusions and Adjustments

Round 1

In previous years, certain spending was included in the Health group, which is no longer included in it, and has since been transferred to other government departments, and therefore other spending groups.

The first two items are the Office of the Minister for Children and the Child and Family Agency, which since 2014 have been transferred over from the HSE to the Children and Youth Affairs spending group.

The third is the Domiciliary Care Allowance, which was included in HSE spending from 2005-2010, but has since moved to the Department of Social Protection group.

So spending that in previous years was included in the Health group, is no longer there, and the Department argued – quite reasonably – that the figures should be adjusted to account for this.

Let’s see how health spending looks, if we exclude the Office of the Minister for Children, the Child and Family Agency, and the Domiciliary Care Allowance from all years, and only count the HSE and the Department of Health.

(Note: Despite repeated requests over the course of more than two weeks, the HSE did not provide figures for the Child and Family Agency for 2005-2007).

For a full-size version of this chart, click here For a full-size version of this chart, click here

As you can see, health funding was higher in 2008 and 2009 than the allocation for 2017, even when we make these exclusions.

Round 2

However, the Department of Health argues that further spending should be removed from previous years, because it too has since been removed from the Health budget.

This gets quite complicated, but here it is:

Before 2015, the HSE got a separate section (known as a “vote”) in Health group spending. Included in gross HSE spending were certain sources of income known as “appropriations-in-aid”.

These were counted as part of gross spending, and are sources of funding that the HSE generates directly for itself, rather than being given to the HSE from the exchequer – which is like the central government current account.

These are items like pension levy deductions from HSE staff, hospital charges, and so on.

Since 2015, the HSE no longer has its own section in the Health group.

And since then, some of these funding sources (appropriations-in-aid) are no longer reported as part of overall gross health spending, although they continue to exist.

So this type of funding has been present every year since the HSE was set up 2004, but from 2015 to 2017, they’re not being reported as part of gross health spending.

Therefore, the Department of Health argues, quite reasonably, that you have to exclude this funding from previous years, in order to make a fair comparison.

Let’s take 2007-2017 (since years before this are not even close to the current level of spending).

For a full-size version of this chart, click here For a full-size version of this chart, click here

Finally, we’re going to something that the Department of Health for some reason did not do – adjust for inflation.

This is essential for a proper, meaningful comparison of figures across years.

Here are the figures, adjusted for inflation using the CSO’s inflation calculator set to September 2016.

For a full-size version of this chart, click here For a full-size version of this chart, click here

As you can see, after all the necessary and reasonable exclusions and adjustments, it is the case that the Budget 2017 investment in health is, in fact, the biggest ever, though not by all that much.

At €14,606,552,000, it is €215.6 million higher than the second-highest investment, which was (adjusted for inflation) €14,390,990,110 in 2009.

No year before 2007 came close to next year’s budget, even after inflation, so we’ve excluded them from this chart.

Also, the figure for 2007 includes funding for the Child and Family Agency. Despite our requests, the HSE did not provide the amount of this funding, but the result is that the €14.2 billion in 2007 slightly overstates the case.

It is worth noting that we are comparing the budget for 2017, and estimates for 2016, with actual spending in years previous to that.

It is possible that actual spending in 2017 may turn out to be lower than expected, but this is unlikely, since health spending is usually higher than budgeted for, not lower.

We rate the claim TRUE.

Population change

This doesn’t effect the verdict, because the claim related to the overall spending allocation for health in the budget, but it’s important to be aware of the role of changes in the Irish population in analysing this.

Firstly, here’s health spending per person from 2007-2017, based on the CSO’s annual population estimates, and the Department of Health’s own projections for 2017 (pg 74).

For a full-size version of this chart, click here For a full-size version of this chart, click here

 

Based on these figures, it would appear that while the overall health budget (the subject of the government’s claim) is higher than ever, per capita spending is not at the level of previous years.

To download a spreadsheet containing all the relevant data, click here.

Update: This article has been revised to add an analysis of population change and per capita spending. 

Originally published: 4 November

TheJournal.ie’s FactCheck is a signatory to the International Fact-Checking Network’s Code of Principles. You can read it here.

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12 Comments
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    Mute Brian Ward
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    Nov 5th 2016, 7:22 AM

    There’s no point in throwing money at something that is falling apart at the seams. YOu could double what was budgeted this year and still have a complete mess. What is needed is a Minister who will cut out the massive excess of administrative personal and overlapping departments that has people doing the same jobs or just pushing paper from one side of a desk to the other. The problem is that no Minister has the guts to do this as it would be political suicide.

    The Government should appoint someone for a fixed term who doesn’t have to worry about being elected and who will weed out the excess baggage across the HSE. Having talked to a person involved in the private healthcare sector they told me that their own research into costs in the HSE showed that about 70% is admin staff. Thats absolutely crazy. The costs should be 70% medical staff and 30% admin. If this problem isn’t tackled then we will still be wasting billions every year on people who are surplus to requirements while not getting the best people and conditions for the people who do the most in the HSE and that is the medical personnel.

    Why else do you hear so many Irish accents in UK, Australian and New Zealand hospitals?

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    Mute P.J. Nolan
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    Nov 5th 2016, 7:43 AM

    @Brian Ward:
    Just try getting that past the unions

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    Mute jane
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    Nov 5th 2016, 7:44 AM

    And each one of those is now looking for a pay rise

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    Mute Brinster
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    Nov 5th 2016, 12:55 PM

    @Brian Ward:

    “The Government should appoint someone for a fixed term who doesn’t have to worry about being elected and who will weed out the excess baggage across the HSE”

    Correct Brian.

    But this is already happening.

    Roisin Shortall is chairing the cross party group which will make long term decisions to correct the absolute lack of strategic planning.

    New Politics is for the most part bunkum but this is one very, very welcome development.

    http://www.irishtimes.com/news/politics/shortall-to-chair-d%C3%A1il-committee-on-health-planning-1.2696362

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    Mute Peter Buchanan
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    Nov 5th 2016, 7:16 AM

    Still left waiting hours & hours in A & E .. Harris is a little spoofer….

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    Mute Martin Sinnott
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    Nov 5th 2016, 7:32 AM

    To many bosses & not enough workers in health system. To many form fillers.

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    Mute Patrick Norton
    Favourite Patrick Norton
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    Nov 5th 2016, 9:18 AM

    I had to wait nearly nine hours in a and e in James on Thursday night with a serious back injury. The amount of junk!e$ and $cumbags there is frightening and they were nearly prioritize over anyone else, system is a joke. Don’t know how nurses and doctors are doing that job. Huge respect for them and two fingers to the useless greedy government.

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    Mute mickmc
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    Nov 5th 2016, 6:59 AM

    Well hopefully health is the budget that cut in order to fund what the unions call pay restorations. Let’s face it, it a black hole anyway and when the government eventually bends over to the teachers, nurses or whoever else is playing the poor mouth I sooner see this budget being raided than a tax increase for the squeezed middle who pays for everything.

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    Mute Simon
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    Nov 5th 2016, 6:58 AM

    Well that’s good

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    Mute leartius
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    Nov 5th 2016, 10:34 AM

    Seldom we see a true verdict for any ministers statements but it will be this time next year before we know if this allocated budget of 14.7 billion is actually spent on health. Take mental health this time last year funds were “ring fenced” but by January this fence and budget was gone. This year 35 million was promised but only 15 million was allocated in budget 2017. The gap between what is promised and what is delivered gets wider every year. The HSE spends more every year on compensation to victims family’s who have being murdered by our health system. Elderly people dying on trolleys was cruel enough but now there lives end on chairs to keep the trolleys numbers down. Our health budget turn solicitors and lawyers into millionaires dragging victims of abuse through every court in an attempt to crush there very souls. The HSE are employing doctors that don’t know the difference between an knee and a elbow and who’s English is limited because they are cheaper than hiring doctors trained in Ireland. We train nurses for health systems worldwide but need to bring in nurses from Asia to keep our own system functioning.
    14.7 billion is a huge budget but will it reduce the 9 hour wait to be see doctor in A&E or stop local GP services from closing down . Harris promises like is smile is as fake as anything that has came before him.

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    Mute Brinster
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    Nov 5th 2016, 12:59 PM

    @leartius:

    “This year 35 million was promised but only 15 million was allocated in budget 2017″

    This was also the subject of a Journal Fact Check.

    Your statement is completely false.

    http://www.thejournal.ie/mental-health-e20-million-cut-budget-2017-facts-3044032-Oct2016/

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    Mute Lee Power
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    Nov 5th 2016, 11:14 AM

    I bleedin love the fact checker!

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