Minister for Health Simon Harris has told the HSE that it would be "prudent" to delay spending millions of euro earmarked for new health service developments this year until it is confident that targets for savings will be realised.
The head of the HSE,Tony O'Brien, recently warned the Department of Health that there was doubt over whether "stretched" targets of close to €70 million in savings would be delivered as planned this year.
The Minister insisted that areas identified as priorities for development by the Government had to go ahead. However, other development areas that could now face delays include plans to invest €10 million for priority staffing in acute hospitals to mitigate risk and a further €3 million to ensure the availability of senior clinical decision-makers in hospitals.
A planned €1.5 million investment in the national ambulance programme and a €1 million allocation for a patient-safety programme could also be held up.
Separately, the Minister also indicated that plans for the HSE to spend €15 million from existing resources on a health service improvement programme could also be delayed if the overall savings targets are unlikely to be realised.
Mr Harris insisted that Government priority areas for development, including acute hospitals, primary care, disability services and mental health, should not be affected.
Budget compliance
The Minister said that it was important for the HSE to monitor progress in developing plans to meet its “stretched” savings targets this year.
“In the event that either the development or implementation of these plans is not proving successful, the HSE should identify and consider other approaches which will not impact services to ensure budget compliance.
“Where the HSE has discretion over expenditure decisions it would be prudent to delay the initiation of such expenditure until confidence exists that savings targets will be achieved while delivering on the service levels committed to in the National Service Plan.”
The National Service Plan, published last month, is essentially the HSE’s agreement with the Government on how its €14 billion budget for the year will be spent.
The Minister’s letter was written in response to a letter sent to the Department of Health in late November seeking approval for the service plan for this year. In that letter Mr O’Brien said the service plan contained some “stretched targets” which had a “high delivery risk”.
Service plan
He said while the HSE intended to remain within the service plan, if these “stretched targets” were not achieved it would lead to “adverse financial variances” of more than €67 million in total.
He said this was made up of €44 million related to historical accelerated income targets in acute hospitals, €14 million in other targets relating to acute hospitals and more than €9 million relating to disability services.
Mr O’Brien said the HSE wanted to put in place additional “supports” including the appointment of additional senior mangers in areas such as industrial relations, human resources, finance, social care and acute hospitals to maximise the delivery of the proposed control and savings measures.
He said that without an expectation that these additional “supports” would be authorised by the Department of Health, the HSE directorate would not have approved the service plan for the year.
