Labour ‘frustrated’ at budget overruns in health department

Labour is growing increasingly unhappy with the performance of Health Minister James Reilly amid budget overruns in his department and his failure to tackle consultants’ pay.

The party is particularly unhappy that the Fine Gael minister sees cuts in the overtime and allowances of HSE staff as part of the solution to the overruns, rather than reducing consultants’ pay.

The HSE is already running about €200m over budget and there are concerns it could reach €500m by the end of the year if not tackled properly now.

“When ministers doing hard things in their own departments to stay in budget see a potential €500m overrun elsewhere, and no real plan to deal with it, they clearly get frustrated,” said a Labour source.

“We’d be much happier if he ponied up on high-paid consultants before going after the low-paid. He’s not willing to look at consultants’ pay. But any reductions should start at the top.”

The party is also concerned that if the overrun escalates, funding ring- fenced for key Labour priorities such as primary care and mental health services could be targeted.

Responsibility for those areas lies with Labour’s two junior ministers in health, Róisín Shortall and Kathleen Lynch.

Any efforts to reduce the budgets for primary care or mental health would cause “a problem” between coalition partners, the source said.

Labour had been “very sceptical” about Dr Reilly’s ability to cope with the challenges posed by the department from the outset, although he had “over-performed” the party’s expectations in some areas.

“To be fair, there’s been no crisis in the hospitals or in terms of trolleys. He put all his faith in the special delivery unit [to tackle waiting lists] and that is delivering,” the source said.

“But there’s no getting away from a potential €500m overrun. That would just be unconscionable.”

A spokesman for Dr Reilly said the minister had adopted a “very clear strategy” for the health services with patient safety coming first.

The minister had decided to seek “flexibilities” from the consultants rather than pay cuts and that had proved successful, he said.

Whereas Labour would argue €50m could be saved from cutting consultants’ pay, the HSE estimated €63m had already been saved in clinical programmes through such flexibilities.

Overtime and allowances were a different matter, it was indicated.

Of the €13bn health budget, some 70% went on pay and up to 18% of that, in turn, represented allowances and overtime.

“That’s about €800m [in overtime and allowances]. We have a budgetary overrun in the HSE of some €200m,” the spokesman said, adding the minister was of the view the payments had to be looked at first before any treatments were cut.

He pointed out that Dr Reilly had ordered a review of expenditure control systems within the HSE.