The health service is facing a shortfall in funding of up to €2.5 billion this year and next year, Health Service Executive chief executive Bernard Gloster has indicated.
The HSE does not have enough funding for what it is doing and is likely to face a deficit of €1.5 billion by the end of the year, he warned on Sunday.
In addition, it is facing a further cost overrun of “very close to €1 billion” in 2024, when the HSE service plan will for the first time include a built-in deficit.
The level of funding provided to the health service in Budget 2024 is “not adequate”, Mr Gloster told RTÉ's This Week programme.
Health received a record €22.5 billion in Budget 2024, but Minister for Health Stephen Donnelly has told colleagues the extra money allocated is only one-third of what is needed.
The extra funding provided in the Budget – €700 million for existing level of service requirements and €100 million for new measures – will allow for the recruitment of 2,200 additional staff and the creation of 22 critical care beds, Mr Gloster said.
However, there will be a “significant slowdown” in the development of clinical care programmes across the health service and 2024 will be “a year of consolidation”.
Mr Gloster said this year’s deficit was mostly due to inflation and an unprecedented increase in demand. The HSE’s energy bill is up 85 per cent, its food bill has risen 30 per cent and cleaning costs are up 20 per cent. Meanwhile, an additional 80,000 patients have joined waiting lists, above what was expected.
The HSE won’t cut services but will try to run the minimum deficit it can, Mr Gloster said, addressing savings in areas such as overtime and agency staffing.
Planned improvements to emergency department care and waiting lists will continue, despite the funding issues, he said.
Any attempt to make the HSE break even next year would “cause harm”, he warned.
Tánaiste Micheál Martin said there needs to be a “deep dive” to examine spending on the health service.
He said the Coalition has allocated “€7 billion-plus” to health since it took office in 2020 and “probably that’ll be a bit higher by the end of the year when the supplementary is allocated”.
Mr Martin said there is a need to “do a deep dive on that and an analysis of that [health expenditure], not just for now, but to make sure that we can plan and provide sustainably into the future because if you look at the rate of increase per annum now, it is certainly heading to 2½ billion to three billion, potentially, when you take supplementaries and so on into account and there are areas that need examination.”
“We need to do that examination in terms of population growth, getting a better analysis on that, ageing population, the degree to which as we age, we’re putting more pressure on services.
“So there is a bit of work yet to be done in respect of all of that,” Mr Martin said while insisting “there has been very significant progress made”.
He said approval had been given for 22,000 extra staff in recent years and there will be the development of surgical hubs this year.
“There is full funding for the waiting list initiatives this year again and for the capacity issues in terms of our hospitals,” he added.
Mr Martin was speaking at Fianna Fáil’s annual Wolfe Tone commemoration at Bodenstown, Co Kildare.
