Donohoe and Donnelly meet over health spending following €500m overrun in four months (2024)

Minister for Public Expenditure Paschal Donohoe on Monday held talks with Minister for Health Stephen Donnelly over health spending.

Earlier this month it emerged that the HSE had overrun its budget by more than €500 million in the first four months of the year. At the same time the HSE’s pay and numbers strategy – the document setting out the total number and type of personnel permitted to be employed for the year as well as the associated pay budget – has not been finalised.

No statement was issued by either the Department of Health or Department of Public Expenditure following the talks which also involved senior officials.

The pay and numbers strategy is drawn up by the HSE but has to be authorised by the Minister for Health. This has not yet happened. Discussions have been under way for some time on what should happen about more than 2,000 posts either filled or committed to last year by the HSE but for which there was no funding.

With no agreement on a staffing plan for the last several months the HSE has, with some exceptions, been implementing a policy of not appointing personnel to replacement positions.

Mr Donnelly said in the Dáil earlier this month that the current recruitment embargo was a “coarse measure” but was needed. “We do not want it to be in place and I am working with the Government to resolve it as soon as I can.”

Meanwhile doctors will tell the Oireachtas on Wednesday that despite Government announcements that record funding was being provided to the health service the reality was that it was not receiving sufficient money to meet the needs of a growing and ageing population.

The chief executive of the Irish Medical Organisation, Susan Clyne, will tell the Oireachtas Committee on Health that the HSE recruitment embargo had resulted in non-consultant hospital doctors (NCHDs) being required to work beyond levels that are safe for patient care.

She will say that the recruitment freeze, which has been in place for seven months, has meant an increase in Illegal and unsafe hours, with 83 per cent of NCHDs routinely working beyond 48 hours per week. “This is illegal in terms of the Organisation of Working Time Act. It is also unsafe for patients. And it is a breach of contractual entitlements.”

Ms Clyne will say that 77 per cent of NCHDs were “being pressurised by their employer to work extra shifts, often at short notice, to cover gaps in the rota”.

“The consistent narrative of record levels of health budgets and the additional numbers employed in the health service masks the reality of the demands on the health service and the deficits in funding for over a decade. While the health service, like all public services, must provide value for money it must be funded appropriately to meet the needs of a growing and ageing population, and that is simply not the case currently.”

Ms Clyne will say that there are now about 2,230 specialist doctors operating under the new public patient-only contract which also allows for them to be rostered over an extended working day and week. However she will argue that the new contract will not, in and of itself, “solve the chronic problems the health service is facing in the context of capacity and workforce requirements”.

“It is not realistic to infer that the health service will see tangible benefits if consultants are consistently rostered outside ‘normal’ working hours. With the deficits in our workforce there is no room for manoeuvre – we are quite literally adopting a policy of robbing Peter to pay Paul.”

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