The Health Service Executive is to receive nearly €370 million less in funding from the Government this year than it maintained was necessary to sustain existing levels of services.
The Irish Timeshas learned that as part of the financial estimates process for 2008 last autumn, the HSE said that it would require a total revenue budget of €14.706 billion to maintain the existing level of services this year.
Internal documents reveal that the HSE actually sought an overall budget of just under €16 billion to deal with emerging cost pressures in a number of areas, and to take account of new developments and priorities.
However, the level of revenue funding actually provided for this year was €14.337 billion.
The HSE has described its financial position for the year as "challenging" and there have been indications that it is considering new measures aimed at allowing it to live within its budget.
Last week it emerged that the HSE in the northeast had drawn up draft cost-saving proposals that would see a significant reduction in services.
The draft memo discussed the possibility of closing the A&E unit at the Louth County Hospital in Dundalk and the recently opened treatment room in Monaghan General Hospital, as well as reducing elective surgery and outpatient clinics by around 20 per cent in some hospitals.
The HSE said no final decisions had been taken in relation to the proposals set out in the draft memo in the northeast.
Separately, health service trade unions told the Labour Court last week that the HSE had introduced stringent new measures to control employment numbers.
The trade union Impact said the HSE earlier this month had "effectively abolished" vacant posts that were unfilled when a controversial job freeze was introduced last September.
In a 105-page submission to the Department of Health last autumn, the HSE said that it needed an additional €1.275 billion in revenue funding to sustain the existing service levels. It said that this money would be required to deal with pay, pensions, new drugs and the increasing costs of demand-led schemes.
The HSE said that it would need over €400 million to meet pay awards and increments for staff this year.
The Department of Health said funds were not issued to the health services by Government in the knowledge that they were insufficient to meet the cost of planned services.
"Each year, the Government decides what level of funding should be made available to the HSE following consideration by the Minister for Finance of the expenditure proposals submitted by all Ministers across the full range of expenditure areas.
"In the case of health, information and views provided by the HSE are taken into account, as well as the Minister for Health and Children's priorities in relation to service developments," it said.
The Department of Health said there had been very substantial additional resources provided in recent years.
It also said it was not unusual for State agencies, and indeed Government departments, to claim they had not been given "enough" funding.
The HSE said its service plan for the year identified the need for it to achieve efficiency savings equivalent to 2 per cent of expenditure.
It also said it was now completing business plans that addressed activity and finance issues at hospital/local health office level.
"The conclusion of these plans will give clarity on the full-year service position," it said.
Fine Gael health spokesman James Reilly said that the HSE should look for efficiencies, particularly in relation to its huge bureaucracy, rather than reducing patients' care.
