The health service’s chief accountant has called urgent meetings with hospital and community services to “reinforce” how quickly such cost-containment must take place.
Hospitals are finding it most difficult to stay within budget — set to go €75.5m over target unless they rein in spending.
The HSE’s latest performance report shows hospital over-runs can be attributed to “significant and extended pressures on emergency department services” over the winter in particular.
“Our priority is to safely progress additional cost-containment measures and to utilise all resources made available to the HSE while balancing financial and service user risks appropriately,” the report states.
As well as hospitals over target, smaller-than-exp-ected numbers of people took up voluntary retirement schemes, meaning payroll costs are too high.
Government delays in bringing in charges for private patients in public beds and delays in introducing planned reductions in GP and other professional fees will negatively impact this year’s budgetary targets.
Up to €60m of income was to be generated by the new private bed charges by year’s end and another €8m-€9m a month was to be saved from May onwards by agreement with professionals providing services for the HSE.
In the first five months of this year, €5.161bn has been spent from the health budget. However, €5.112bn should have been spent, meaning that there is already a deficit of €49m.
Health chiefs say €15.5m of the shortfall is coming from failure to make sufficient cuts in payroll.
Enthusiasm for the Croke Park and Haddington Road Agreements appears to be draining among staff, says HSE management.
“Our regions are reporting that we have already experienced a reduction in the pace and availability of flexibility under the Croke Park Agreement” the report said.
“The assessment is that this has already contributed to slippage on our cost containment programmes.”
The HSE is researching whether the Haddington Road deal will make the €150m in savings this year, as they had planned for in their 2013 service plan. Without such research, they say they could not “validate with certainty” that they will make expected savings.
The HSE budget has been cut by a fifth compared to 2008. Staffing has also fallen by 11,320 since 2007.