Health spending is running more than €500 million over budget for the first four months of the year, the Department of Health has told an Oireachtas committee.
Department of Health secretary general Robert Watt said that about 75 per cent of this amount was in the acute hospital sector.
He said there would be a supplementary estimate needed for the health service this year.
Mr Watt also said the current moratorium on recruitment in the health service was not satisfactory.
He said proposals for staffing in the health sector - known as the pay and numbers strategy - were being discussed by Minister for Health Stephen Donnelly with other Ministers in the Government.
Mr Watt also told the committee that the new contract for hospital consultants – under which they can treat only public patients in public facilities – had now been accepted by 51 per cent of the medical specialist workforce as of the beginning of May.
He said that 2,229 consultants had now signed up to the new contract and that this was “delivering on the Government’s commitment to phase out private practice from public hospitals”.
Health service chiefs also maintained that the provisions of the new contract also meant that there were more senior doctors in hospitals at weekends.
HSE chief operations office Damien McCallion said there had been a 30 per cent growth in the number of discharges from hospital on Saturdays and 10 per cent on Sundays.
HSE chief people officer Anne Marie Hoey said 470 of the consultants on the new contract were new entrants to the health service. She said the remainder had transitioned from other older contracts.
The new contract has a pay scale ranging from close to €220.000 to more than €260,000 on a six-point scale.
Ms Hoey said that since the new contract was introduced the number of applications for each consultant post had doubled from about two to four.
She said there had been a huge increase in interest in the new public-only consultant positions both nationally and internationally.
Mr Watt said that waiting lists were down in 2023 for the second year in a row. He said 177,000 more patients were removed from waiting lists last year than in 2022. He also said that hospital emergency departments were are seeing increased levels of demand, with nearly 48,000 extra attendances up to mid-April.
However, he said despite this there has been a 10 per cent drop in patients waiting on trolleys in the same period.
Mr Watt said the number of older people in the country would grow significantly in the years ahead.
“We currently have a population over the age of 65 of 800,000. By 2031 that number will have reached one million; by 2041 (it will be) 1.3 million and it will be nearly 1.6 million by 2051; double that of today. ”
He said notwithstanding the progress that had been made in the health service, “we simply must do better with the resources at our disposal to meet that challenge”.
“We need to be able to identify areas where our investments in community and primary care services, and our reformed governance, will deliver value to the patient and the taxpayer and make health services more sustainable. ”
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