Ministers have not yet reached agreement on any special funding package to pay for the implementation of the long-mooted Sláintecare health reform initiative which aims to transform the health service over a 10-year period.
The initiative, first announced in May 2017, requires a €3 billion transition fund to cover the cost of implementing the reforms.
Amid growing concern within Government over an accelerating health service budget deficit this year, it is understood the Department of Finance is insisting there can be no extra funding for Sláintecare outside the normal budget estimates process.
Sláintecare aims to radically restructure the health service from a current mix of public and private care into “an affordable, universal, single-tier healthcare system, in which patients are treated promptly on the basis of need rather than ability to pay”. A key element would be shifting care away from hospitals and into the community.
The Opposition is likely to press the Government on the whereabouts of the significant additional State investment required under the plan
The Cabinet is expected to direct on Wednesday that a new action plan be drawn up within three months for the initiative.
It is understood that talks took place in the Department of Finance and Department of An Taoiseach on Monday following arguments over funding for Sláintecare which have been running for weeks now within Government.
Minister for Health Simon Harris had promised repeatedly for months that he would bring a Sláintecare implementation plan to the Government.
Three months
It is understood Mr Harris will now bring what is being termed “an implementation framework” to Cabinet when it meets in Kerry on Wednesday.
Sources said it was expected the Government would task Laura Magahy, who was appointed as executive director of the Sláintecare project last week, to draw up an action plan within three months.
The Opposition is likely to press the Government on the whereabouts of the significant additional State investment required under the plan, including the €3 billion transition fund to cover the cost of implementing the reforms.
Minister for Finance Paschal Donohoe is also expected to bring to Cabinet a half-year expenditure report which will show the health budget significantly exceeding its targets.
The Irish Times reported last month that the HSE deficit for the first six months of the year was expected to exceed €200 million. It is understood the latest projections suggest that overspending is on track to be well over €500 million for the full year.
Sources said a separate, but linked, dispute within Government over the 2017 HSE deficit of about €140 million (or €160 million when voluntary hospitals and agencies are taken into account) remained unresolved. Under legislation this deficit should be considered as a first charge on the HSE accounts for this year.
GP contracts
The Cabinet has already decided on an amount it is prepared to pay for a new contract with GPs, which will be central to the implementation of the health reforms. The Government is looking for an enhanced contract with GPs which would see them deliver new chronic disease management services and a range of other objectives as part of a deal which would see the reversal of austerity-era cuts. However no agreement on such a deal has been reached with doctors.
Mr Harris is also expected to ask Cabinet on Wednesday to approve legislation which will provide for the re-establishment of a board of the HSE.
It is understood the Minister will seek the board when appointed to prioritise a full examination by the new director general of the HSE of the current senior management in the HSE – including structure, responsibilities, capacity, skills and experience.
