HSE chief says budget allocation must be exceeded to avoid harm to patients

HSE chief Bernard Gloster warned that the budget shortfall will mean cutbacks in funding for development and clinical programmes in areas such as cancer and stroke care. Picture: Denis Minihane

The HSE’s chief executive has admitted harm will "certainly" be caused to patients if the HSE does not spend more than was allocated to health in last week's budget.

Bernard Gloster will build a deficit into the next service plan he submits to the Department of Health.

Mr Gloster also warned that the budget shortfall will mean cutbacks in funding for development and clinical programmes in areas such as cancer and stroke care which will have an impact in years to come. 

The Government gave €22.5bn to the Department of Health in total to fund healthcare as part of Budget 2024.

Mr Gloster said that while he believes an extra €2.4bn to €2.7bn will be required for the coming year, just €800m extra was forthcoming compared to 2023. He said the level of funding provided to the health service is “not adequate”.

If the demand was on the health service and me as the CEO to produce a breakeven service plan next year, then we would certainly cause harm [to patients]. 

"I don’t envisage that we’re going to be doing that,” the HSE chief executive said.

“Hence why I have said very publicly and very clearly, I’m not planning to achieve the highest level of deficit possible, I’m working to achieve the lowest level of deficit possible.

"But make no mistake about it, our service plan for 2024 that we will put forward to the Minister [for Health] will include a built-in deficit, which is the first time, in my memory of service plans, that would be the case."

Asked if this made the Government’s budgetary allocation to the HSE a “fiction”, Mr Gloster told RTÉ radio: “I think that’s perhaps for other people to decide.

We have very significant levels of funding, we have very significant levels of staffing but we do not have enough to do what we’re currently doing today. 

Mr Gloster confirmed there will be a “significant slowdown” in both development and clinical programmes run by the HSE in areas including cancer and stroke care.

However, he said critical areas like emergency care and scheduled care are “heavily funded” and that improvements will be pursued by the HSE.

Speaking to reporters on Sunday, Tánaiste Micheál Martin defended the funding allocation, saying there is always commentary on health budgets.

In particular, Mr Martin said that there needs to be a “deep dive” over the health service spend to then identify any future trends that may impact on HSE delivery, including population growth.

Stephen McMahon, co-founder and director of the Irish Patients’ Association, agreed that an audit of the healthcare system is needed.

“There is something wrong with controls when we are only aware of massive overruns halfway through the year,” Mr McMahon said. He questioned whether or not the HSE’s board risk committee signed off on the latest assessment.

“There are four domains of risk to patients — clinical, medication, equity of access, and finally management — how they spend and use the resources can have a direct impact on patient safety."

He questioned if HSE management is focused on the organisation itself or the patient.

Meanwhile, Sinn Féin’s health spokesperson, David Cullinane, said the Government put Mr Gloster in an “impossible position”, describing the decision not to allocate additional funding as “reckless”.

“The Government must accept the consequences of underfunding the health service in the year ahead. I’m concerned it will have dire and catastrophic consequences for patients within the health service,” Mr Cullinane said.