HSE defends budget underspend

The Health Service Executive (HSE) today insisted patient care improved last year even though it admitted failing to spend nearly a fifth of its €555m budget.

Despite having earmarked €97m for major projects such as Dublin's Mater Hospital, the HSE said a lack of anticipated progress forced it to hold the money back.

Opposition TDs and the campaign group People with Disabilities Ireland (PwDI) rounded on the HSE accusing it of allowing bureaucracy to block reform.

There were also delays in spending for the National Rehabilitation Centre.

Michael Ringrose, PwDI chief executive, said someone had to be held to account.

"The sense of acceptance of the slow pace of delivery within the public service is simply not acceptable," he said.

HSE management agreed a deal with the Government to spend €71m of the surplus on day-to-day costs rather than hand it back to the Exchequer.

They are also in talks with the Department of Finance to include the remaining €25m in this year's budget. It is understood special Government approval is needed.

The HSE offered the following explanation for the massive underspend: "The capital underspend was partially due to the lack of anticipated progress on a number of major projects (such as the Mater Misericordiae Hospital project and the National Rehabilitation project).

"A necessary transition to new and improved capital monitoring and management structures also contributed."

Despite the spending difficulties, the HSE said there was a 60% drop in the numbers of people waiting for admission from A&E units even though attendance went up 3.3%.

The HSE said spending was now being managed by a new body known as the Estates Directorate which was working alongside the Primary, Community and Continuing Care and National Hospitals Office committees.

"The Estates Directorate has brought a greater focus and momentum to the planning and development of major capital projects," management said.

But newly-elected opposition TDs were quick to brand it bureaucracy with Fine Gael health spokesman Brian Hayes accusing the HSE of organisational inability.

"The handing back of €90m because other developments are stalled indicates a bureaucratic block to channelling funding to areas of desperate need and it must be explained by the HSE," he said.

Liz McManus, Labour Party health spokeswoman, said the underspend showed failures at the highest level.

"Around the country patients are suffering for wont of sufficient beds, equipment, and healthcare facilities," Labour's deputy leader said.

"It is inexcusable that the HSE, as the body established to introduce greater efficiency to the health service, has been unable to spend its not over-generous annual budget for these new facilities."

Caoímhghin O'Caolain, Sinn Féin's health spokesman, said it was almost beyond belief the money was not spent as hospitals battled to control superbug viruses.

"Public money for hospital developments has gone unspent while MRSA spreads in our hospitals because we do not have enough single rooms and isolation units to combat this and other serious infections," Mr O'Caolain said.

"This money should have been used to provide those units."

Meanwhile, the Irish Medical Organisation said it will go back into talks with Minister for Health Mary Harney on new contracts for consultants.

In its annual report the HSE highlighted achievements in 2006. More than half a million patients were treated in hospital; A&E units dealt with 1.26 million patients; there were 62,745 births; and 11.4 million home help hours delivered.

HSE chief Professor Brendan Drumm praised staff for their work: "2006 was the year the HSE started to introduce greater consistency and accountability and thanks to the tremendous commitment and efforts of thousands of staff, we provided many excellent services, many services have improved and others will continue to get better."