No new management consultancy deals in HSE without Gloster sign-off 

HSE chief executive Bernard Gloster. File picture: Denis Minihane

As concern grows around the health budget, HSE chief executive Bernard Gloster has directed that no new deals with external management consultants can be put in place without his personal sign-off.

Details of deals worth millions of euros with firms such as PWC Ireland and EY caused outrage earlier this year, with an estimated total of €113m for last year alone.

The effort to stem costs comes as questions are being asked about whether the health budget for 2024 is enough to meet the needs of a growing number of ill patients relying on services.

This week, the HSE said: “All national directors were directed that no further new external consultancy or additions to existing arrangements are to be put in place unless expressly agreed in advance with the CEO”.

It is not yet clear what the approval process will be or what minimum standards CEO Bernard Gloster will apply to deals which pass inspection.

However, ICT spending approved through the Digital Government Oversight Unit under the Government chief information officer is exempt from the cuts.

Also exempt is consultancy work related to construction linked to the capital plan.

HSE directors have to ensure spending on these external firms during October to December is “at least 30% lower” than during the first three months of this year.

They were also told these reductions will continue for 2024.

“Annual savings are targeted to be in the region of €35m to €40m,” said the spokesman.

The HSE accepts, he said, that support from such firms can offer value, but only when “very carefully targeted for specific, generally short-term, uses” in cases where the HSE lacks staff expertise.

Sinn Féin health spokesman David Cullinane welcomed the move, but said the HSE has come quite late to this decision.

“It is going to take some time for savings to be made, I think those savings need to happen year-on-year over a number of years,” he said.

Savings are also needed, he said, in the area of fees for temporary agency health workers and legal fees.

“Then there is the wider issue of outsourcing healthcare,” he said. “I’ve been saying for some time that all of these spends have become a runaway train for a long number of years.”

Referring to the specific savings projected, he said: “It’s not going to have any real impact on the deficit for this year, or for next year, but it is a start.

“The fact that we’ve come so late to this and allowed all of this expenditure to balloon and get out of control is the problem. This minister and previous ministers of health have to take responsibility for that.”

Meanwhile, a recruitment freeze on managerial roles in the HSE remains in place, with trade union Fórsa having launched industrial action among their members in protest. They called for investment in staff rather than continued high spending on external firms.

This is alongside a contentious new freeze of additional hiring for key frontline roles such as doctors in training (NCHDs) and carers. This has been linked by health unions to potential risks for patient safety and delays over the winter season.