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All about the money

It emerged last week that the HSE was €270 million over budget by the end of July. If this overspend continues, it could be facing a similar record-breaking bailout to last year, where €680 million was required at year-end. We were told last year’s bailout was primarily due to increased spending by the HSE of more than €500 million on increased levels of medical activity, drugs, the cost of State claims and front-line staff, and that this had already been included in the base for 2015’s expenditure.

So what is the excuse for this year’s overrun? The 2015 health budget saw a modest rise after the steep cuts endured through the recession, but it is obvious that was simply not enough. As Dr Sara Burke writes in her column in this issue, a major rethink in how we fund our health services is needed ASAP. Next week’s 2016 Budget launch will be a real test for the under-pressure Minister for Health. The HSE’s demand that it be given an extra €1 billion has already been shot down but it is clear that it needs an allocation that will allow it to deliver the required healthcare within budget.

We’ve heard much about the ‘money follows the patient’ funding model being introduced by the HSE but there has been little real progress. Instead, as Dr Christine O’Malley points out in her column in this issue, patients on hospital trolleys are not properly coded or funded, compared to directly-admitted patients.

Along with this bizarre situation, we have the prospect of hospitals that were previously given extra money to help their struggling emergency departments and outpatient lists now facing fines and budget reductions for not making the national waiting time targets.

We also have consultants and rural GPs saying that it is not financially viable for them to work in our health services anymore.

On the — rather sparse — ‘plus’ side, the Government’s new capital plan (2016-2021) has allocated €3 billion for a number of high-profile health projects. While most of these projects have already been announced on more than one occasion, and some time frames are missing, it is a very welcome boost.

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