The HSE will ask the Government to provide an additional €199 million in funding for this year.
The Irish Times has learned that the health authority will record an overall net deficit of €219 million for 2013. However, about €20 million is to be provided to the HSE from a surplus reported in the Department of Health's budget for this year.
It is expected that Ministers will consider the HSE supplementary estimate at a Cabinet meeting tomorrow. It is also scheduled to be debated at a hearing of the Oireachtas health committee on Thursday.
The overall financial deficit is less than the worst-case scenario of €286 million which the HSE projected in correspondence to the Department of Public Expenditure and Reform several weeks ago.
However, it is higher than the deficit for the year of about €150 million forecast by the Minister for Health James Reilly following the budget in October.
A HSE spokesman declined to confirm the figures for the financial deficit. However, the spokesman said the HSE's financial out-turn for 2013 was "remarkably good considering certain matters that had arisen over the course of the year".
Government policy issues
Over the last 12 months the HSE has had to deal with financial pressures generated from a number of issues, particularly Government policy issues, outside of its control.
This includes a Government decision not to seek €104 million in accelerated payments – essentially payments in advance – from the health insurance industry, as well as delays in introducing legislation to allow for greater scope to charge private patients treated in public hospitals. This measure was to have generated €60 million this year, but was deferred until 2014.
Separately, a six-month delay by the Government in introducing cuts to the fees of healthcare professionals such as GPs and pharmacists meant that only about half of the €70 million target for savings earmarked in this area will be realised this year.
The HSE’s budget for this year was also based on the assumption that €150 million in savings would flow from the Haddington Road agreement on public-service pay and productivity.
However, it is expected to be confirmed this week that there will be a shortfall of €50 million on this target.
Talks between the HSE, the Department of Health and the Department of Public Expenditure and Reform on the supplementary funding for this year have been going on in tandem with talks on the controversial service plan for the HSE for 2014.
The HSE has been asked to generate savings of €666 million next year. A key element of the planned savings is a "probity" exercise in relation to medical cards which had a target of realising €113 million. In addition, a further €20 million in savings was sought in other parts of the budget for primary care services.
Service plan
The Irish Times reported at the end of November that
HSE director general Tony O’Brien had warned in a letter accompanying the service plan that the scale of cuts envisaged to spending on medical card services was being taken against the advice of both his organisation and the Department of Health.
The HSE service plan is being assessed by the Department of Health, the Department of Public Expenditure and Reform and the Department of the Taoiseach.
