HSE director general Tony O’Brien privately warned the Government last November that the health service is facing its most difficult year in a decade due to a chronic lack of money and the “public perception” that austerity is over.
However, internal correspondence obtained by the Irish Examiner shows senior backroom Government officials forced the most overt warnings to be removed.
The details have been revealed just 24 hours after Taoiseach Enda Kenny admitted the Coalition has “failed” to keep its promises to solve a series of problems in the system, as the deepening health service crisis takes centre stage in the general election campaign.
And while a Department of Health statement sent to this newspaper stressed that the majority of additional funds given to the HSE are being spent on covering 2015’s overspend — the records will add further credence to opposition claims Government has published a “fraudulent” 2016 health plan.
According to the FOI documents, on November 17, Mr O’Brien wrote to health department secretary general James Breslin raising concerns about funds for 2016.
He said stark choices have to be made “given the rising public expectation around access to health... and the public perception in relation to the end of austerity”, adding the problems “will make 2016 the most difficult year the health service has faced over the last 10 years”.
On November 19, Mr Breslin responded by questioning the “realism” of the view and told the HSE chief to delete phrases like “residual funding shortfall” and “significant operating shortfall” from the draft plan, adding the official increase in funds for 2016 should be better emphasised.
After a number of extensions to the document’s publication, which is meant to take place within weeks of the wider October budget, on December 4, Mr O’Brien sent a second draft to Health Minister Leo Varadkar.
The letter noted the plan “does not allow us to progress as far as we would like” and that “this is significant in that it leaves a considerable amount to be done in 2017” due to the one-off nature of a number of funding gap fillers.
On December 5, Mr Varadkar wrote to Mr Breslin to say “a few things might need tweaking [in the plan], especially around presentation”, and again stressed the need to emphasise the €817m funding increase for 2016.
Five days later, on December 10, Department of Public Expenditure and Reform official Niamh Duff wrote to the Department of Health saying while overspending hospitals must face a “hard edge” response, the plan’s publicly claimed ways to address the €150m funding shortfall in the facilities “lack detail and credibility”.
When the detailed 172-page 2016 HSE service plan was finally published six weeks late on December 16, Mr Varadkar strongly rejected Fianna Fáil leader Micheál Martin’s claims that the document is “fraudulent”.
The final report said hospitals would begin the year €150m short of what they need and warned of the “substantial financial risk” facing the system.
While welcoming the “modest” €817m increase on the 2015 budget, it noted just €97m is left for new measures after last year’s debt is paid off and that an EU supplementary budget ban means “challenges” would go unaddressed.
Sinn Féin deputy leader Mary Lou McDonald separately confirmed her party will fully honour public sector pay hikes for even the most senior workers, while both Renua and the Social Democrats raised further fiscal space concerns.
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