HSE budget: Hospitals facing €100m funding shortfall

Public hospitals are facing a €100m funding shortfall next year which could see waiting lists increase and service cuts considered “as a last resort”.

The situation is outlined in the HSE service plan, which says despite a €50m once-off income collection from insurers the public hospital system will still be under-funded throughout the next 12 months.

As part of the health service budget for next year, hospitals will receive €4.137bn, a figure that is up by €126.3m — or 3.1% — on 2015.

However, while the figure has been welcomed by health service officials, due to the supplementary budget this year hospitals will in reality only receive €83.5m — or 2% — of an increase in 2016, a figure the HSE admits is not enough to meet demand.

Pages 31, 32, and 91 of the HSE report state that “when account is taken of the 2015 cost of services, expected cost growths and initial cost saving measures, this leaves a preliminary funding shortfall of €150m to be addressed”.

While €50m of this can be cancelled out by “historic accelerated income collection” from insurers, the figure remains €100m below what is required to adequately run hospitals at their current level.

The HSE plan states that “options to address the remaining funding shortfall have been considered including aligning activity levels to the funding available” — a euphemism for cuts — but stressed this is “very much as a last resort”.

Health Minister Leo Varadkar said yesterday he will not envisage any cuts and that money can be made available by moving it from other areas of the health service.

While the HSE plan has stressed other efficiency measures to deal with the clear funding gap — including a “very substantial cost control and cost reduction by the groups of hospitals” — they are “very challenging and carry significant delivery risk”.

The HSE plan states that up to 10,000 day case patients may be treated in primary care units instead of hospitals next year as day case activity is currently at 100% capacity.

It also notes that emergency departments are operating at full capacity, while long-standing targets to ensure children and adults are seen within five months and 18 months, respectively, are not being reached by the system — a situation that is unlikely to change during 2016.

— Fiachra Ó Cionnaith

Political Reporter