HSE targets cutbacks as overspend hits €260m

THE way in which private insurance income is collected by the Health Service Executive is “not sustainable”, agency doctors are costing too much and the medical card scheme is €134 million over budget.

These are just some of the issues raised in the HSE’s latest performance monitoring report which reveals an overspend of €260m to the end of September.

Overall, the executive is projecting a potential deficit of €320m for the end of the year, an improvement from a projection of €405m in August, which shows that savings are being made.

However, the report states that in order to achieve this, the health system will have to “intensely manage cost” at every level of hospital and community services to try and come in on target by the end of the year.

In relation to private insurance, the HSE maintains the current income charging and collection regime with private insurers is not sustainable, and that it is dependent upon improving collection figures by €100m before the end of the year.

It says achieving this target will require the “active support” of the minister and the Department of Health.

The average monthly spend on agency doctors has increased by 39%, despite the reduction in the cost of agency hours.

The report explains that until all junior doctors from India and Pakistan are in place, the full effect of planned reductions in agency costs will not be realised.

Hospital deficits are running to about €142.2m as they continue to deliver services above service plan targets. Four hospitals will face “cash pressures” before the end of the year, according to the report — University Hospital Limerick, Galway University Hospital, Tallaght Hospital and Our Lady of Lourdes in Drogheda.

“Another factor is a shortfall of €21.8m in income billing activity. This is because of some fall in the level of privately insured individuals, use of private rooms for infection control, historically high targets and in some cases sub-optimal use of private beds,” the HSE said.

Childcare also remains a significant financial issue, and is running a deficit of €47.7m. According to the HSE, while this matter is being addressed by the director of childcare services it is unrealistic to expect that he can recover this level of cost without significant service impact.

“Supplementary funding will be required to address the shortfall in childcare services, many of which are statutorily based,” the report states.