Health Minister Simon Harris received a stinging rebuke from one of his most senior Cabinet colleagues over applications to increase the supplementary, or overrun, health budget for 2020, the Irish Examiner can reveal.
A letter from Minister for Public Expenditure and Reform Paschal Donohoe to Mr Harris on August 13 of this year expressed the former’s “extreme disappointment” that, rather than attempting to rein in the Department of Health’s budgetary overrun, health officials were instead proposing that figure be extended by a further €60m.
“I would like to underline that there is no sanction for a budgetary overrun of this magnitude,” Mr Donohoe said of the department’s initial estimate that a surplus of €365m would be needed in Budget 2020, adding that that figure would “seriously erode the Government’s scope to bring in a budgetary package in October”.
“I am extremely disappointed to hear that… an overrun of the magnitude of €425m is now a ‘best case scenario’ with indeed substantial upside risks to this estimate,” he added.
Mr Donohoe’s budget speech this month was largely seen as being reflective of a prudent stance necessitated by the ongoing costs and unknowns surrounding Brexit.
However, his demeanour when delivering the health budget is somewhat at odds with his tone in writing to Mr Harris just two months prior, with Mr Donohoe saying this year’s numbers represent a “turning point” for health, as the surplus would total less than half of that seen in 2018’s budget (a record €700m), suggesting that the savings demanded were indeed found in time.
Overall, the health budget for 2020 rose by €1bn to an all-time high of €17.4bn.
Mr Donohoe’s rebuke of Mr Harris in August went further, however, with disbelief expressed that health officials had “no cost mitigation list drawn up, have no intention to prepare one, and indeed are of the view that they have no mandate to do so”.
“To be very clear this is not an acceptable position,” Mr Donohoe said not once but twice in his letter.
Scorn was also poured on Mr Harris’s proposed response to the de Buitleir report into the removal of private care from public hospitals, which was eventually published later in August after a delay of six months.
That report proposed a 10-year timeframe for the removal of such care from the public service, with a key recommendation being that consultants’ salaries be raised by €51,000 per annum to pre-recession levels of €182,000 per year in order to fill a record list of vacancies.
“I am also very concerned with respect to recent media reports indicating that the Government will address new entrant consultants’ pay in the autumn with the reports indicating you intend to invite all interested parties to a process in the autumn,” said Mr Donohoe.
“The focus of your department needs to be on addressing the significant financial challenge facing the health budget rather than new initiatives.”
He said substantial funds held over by the Department of Health and the HSE would have to be reviewed, with “an imperative to ensure that these funds are not disbursed until this review has been completed”.