Donohoe says health service should be running within allocated funding

Minister for Public Expenditure Paschal Donohoe and Health Minister Stephen Donnelly (Niall Carson/PA)
Minister for Public Expenditure Paschal Donohoe and Health Minister Stephen Donnelly (Niall Carson/PA)

Minister for Public Expenditure Paschal Donohoe has said there are accounting and management issues within the health service as he defended this year’s budget allocation.

His comments come amid criticism over the level of funding provided to the Department of Health in the recent budget.

The minister has previously insisted that the 22.5 billion euro allocated to the Department of Health in Budget 2024 will not be revisited.

HSE chief executive Bernard Gloster has warned that the amount is not adequate to run the health service at the same levels as this year.

The Department of Health is already facing an overspend of around 1.5 billion euro this year – an overrun that will require a supplementary estimate allocation for 2023.

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Minister for Public Expenditure Paschal Donohoe said that the health service should already be operating within its allocated funding (Niall Carson/PA)

Speaking on Wednesday, Mr Donohoe said he believes there are medium-term risks in the “underfunding of health services” because of an ageing population but added that the health service should already be operating within its allocated funding.

“That makes the case for me that before that [demographic] change becomes intense and imminent in Ireland, we’re still able to run our health services broadly in line with the funding that was made available.”

He said it has been a persistent feature for many years that the health service has required additional support for staffing changes or “health events”.

“If you look at the funding that’s available for the Department of Health at the moment at 22.5 billion euro, it’s a record level of funding for the Department of Health in recognition of the challenges that our health service are clearly facing.

“I understandably will make the case that there are issues in relation to financial control and management that do need a continued focus and we need to be better on.

“But I’m also conscious of the fact that in the aftermath of the pandemic, some of the activity and some of the changes that in particular our hospitals are experiencing, is different to what we would have expected.

“That is why we’ve increased the covid reserve by half a billion euro for the health service and one of the issues that I’ll be working with [Health Minister Stephen Donnelly] on in the time ahead will be, in addition to management and accounting issues which both of us acknowledge are there, to properly interrogate the demand in our health services and what impact that has on budgeting.”

Mr Donohoe said the three leaders of the coalition parties were fully involved in discussing every element of the budget, including the allocation for health.

He said discussions were undertaken in a “collegiate manner” and an agreement was reached.

“What I just want to recognise is the very important and demanding work that Stephen does as Minister for Health.

“My commitment is to two things. Firstly, to asking of the Department of Health, as we do with all Government departments and I’m working with Stephen on this, which is that spending is in line with funding that is available.

“And then secondly, working with Stephen to respond back to the challenges that our health service is facing.”

Asked about recent reporting on tensions with Minister Donnelly during budget negotiations, Mr Donohoe said comments on his choices are a feature of his role as Minister for Public Expenditure.

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There were tensions between Health Minister Stephen Donnelly (pictured) and Paschal Donohoe during budget negotiations (Niall Carson/PA)

He added: “I’m not going to be engaging in a war of words with anybody. I have the height of respect for Minister Donnelly as a progressive, ambitious and highly effective minister for health.”

Asked about whether he expected a deficit in the health service next year, Mr Donohoe said he could not rule it out.

The public expenditure minister was speaking at the launch of the Government’s civil service menopause workplace policy framework.

The framework was developed in partnership with the Women’s Health Taskforce in the Department of Health and under the guidance of clinical leads in women’s health and occupational health in the HSE and Civil Service.

It is designed to give an overarching structure to guide civil-service organisations when developing menopause policies and identifies ways in which they can support employees, such as offering workplace adjustments.