THE HEALTH SERVICE Executive deficit is likely to hit at least €1bn this year, The Journal understands.

During the summer, Public Expenditure Minister Paschal Donohoe said large overspends in the Department of Health cannot continue.

The rising deficit is set to create further tensions within Government, the Department and the HSE just one month out from the Budget.

As reported in last week’s Sunday Independent, a disagreement has taken place between the HSE and the Department of Health in relation to the size of the budget shortfall.

In a text exchange from earlier this year between Robert Watt, secretary general of the Department of Health and former HSE chief Stephen Mulvanny, Mulvanny accused the top civil servant of plucking figures “out of the air”.

At the time, Watt maintained that the budget overrun would amount to €500mn this year but HSE chief Mulvanny said it would be more than €2bn.

According to Minister for Health Stephen Donnelly the overspend to July has so far ran to approximately €600mn.

A well-placed source told The Journal that the overspend for this year is likely to come in at least €1bn.  

Speaking to reporters at the Fianna Fáil think in in Tipperary yesterday evening, the Minister said that one of the drivers of this overspend is the HSE “spending money in areas where it should not be spending”.

He said this includes hiring into unfunded posts, spending on agency work and overtime “that the HSE is not provisioned for”.

Donnelly said he is working “very closely” with the current HSE chief executive Bernard Gloster and officials to implement measures to drive the budget overspend down.

“For example, Bernard Gloser has implemented some time ago a hiring freeze on management and admin grades. They have targets in place in terms of agency and overtime and so forth,” the Minister said.

Donnelly added that the second driver of the budget shortfall is “price and volume levels that were not provisioned for” – i.e. more patients than the HSE expected. He said this was a significantly bigger driver of the overspend.

“The number of patients presenting is higher than was anticipated this time last year. We’re seeing it in Ireland, we’re seeing it right across Europe.

“We’re seeing a very significant post-Covid surge, and we’re seeing healthcare inflation higher than was provision for as well,” the Minister said.

He added: “Part of this is within the control of the HSE and that’s the bit they’re working very hard on and part of it is not in control of the HSE. It’s demographics, it’s post-Covid, it’s patient volumes, and it’s prices of medicines and wage increases and so forth.”

Free contraception

Elsewhere, the Minister said that he would like to see progress continue in relation to the rollout of free contraception for women.

At the beginning of this month, the free contraception scheme was expanded to include women aged 27-30.

The scheme was launched in September 2022 for women aged 17-25, and a few months later was expanded to include 26-year-olds.

Donnelly would not be drawn on pre-Budget discussions he has had with Finance Minister Michael McGrath in relation to further expanding access to free contraception to women over the age of thirty but he said he would like to see “progress continue” on this front.

“I’d like to see us continue with making healthcare affordable for patients. I’d like to see us continue with the rollout of services like in women’s health care and oncology and youth mental health and others,” Donnelly said.

With reporting from Christina Finn.