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Covid-19 creates financial uncertainly in coming year – HSE annual report

The HSE’s annual report for 2019 admits that the emergence of Covid-19 means that many savings earmarked for this year will not be possible and that the eventual cost of the pandemic to the health service will be “immense”.

At the end of 2019, the HSE delivered a “small  surplus” on its non-capital expenditure of €60.5 million or 0.35 per cent of its total funding, according to the recently published Annual Report and Financial Statements 2019.

“2019 was a year of continued challenges for the HSE driven the by the complexities of on-going demand for services in our acute, community and social care services,” according to the report.

“Significant efforts have been made during 2019 to improve the overall financial planning and financial management of the HSE, which resulted in the delivery of a small surplus on our non-capital expenditure of €60.5 million or 0.35 per cent of total funding.”

Elsewhere, the report notes that “this surplus arose primarily as a result of one off funding measures and savings that are not expected to be replicated in 2020”.

The onset of the Covid-19 pandemic hangs over the report, with the Executive noting financial uncertainly in the coming year.

“Covid-19 has had a huge impact on the HSE, the services we provide, our staff, and the populations we serve,” according to the report.

The report states that the Executive “has clearly flagged that it will not be possible to deliver on many of the savings measures set out [for 2020]…due to the need to apply resources to the Covid-19 response as it continues to develop along with the requirement to maintain all existing capacity and open additional capacity as part of that response.”

This is the first HSE annual report prepared since the re-establishment of a HSE board in June last year.

“As part of the response to Covid-19, a range of significant and essential changes has been put in place by the HSE and this provides an opportunity to identify changes which should be retained in the future,” the HSE Board chairperson Mr Ciarán Devane writes in his introduction to the report.

“Doing so will ensure that we capitalise on the gains that have been made during the crisis, minimising long-term impacts for patients and staff while maximising value for the taxpayer.

“The implementation of the long-term policy direction set out in Sláintecare will continue to be a key focus for us in 2020 and beyond.”

HSE CEO Mr Paul Reid, writes in his introduction that the “financial implications of Covid-19 will… be immense”.

“The key priority for the HSE during 2019 was to maximise the provision of safe services to the people we serve, and to finally get a grip on the health budget,” according to Mr Reid.

“At year end the budget is under control. However, this will be an ongoing challenge in the context of the ever-increasing level of demand for our services which is influenced by factors such as a growing population with an ageing demographic, advances in technology and clinical practice, as well as an on-going societal and economic change.”

The reports notes that at the end of 2019 there were 119,817 whole time equivalents (WTEs) employed by the HSE and section 38 agencies.

“Since 2018, overall staffing levels have increased by 1.7 per cent or 1,960 WTEs.”

The report also states that “the overall pay bill of the health service, excluding voluntary service providers and superannuation, increased by €364 million (7.4 per cent) in 2019 to a total of €5.3 billion . Basic pay increased by €179 million (4.9 per cent) and other allowances increased by €61.1 million (9.9 per cent).”

Total capital expenditure in 2019 was €688 million including €603 million for capital projects and €85 million for ICT capital projects. This included capital grants to voluntary agencies of €325 million .

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