The Minister for Health Stephen Donnelly requested additional details on “expenditure management and control” from the HSE in its National Service Plan 2023 (NSP) in response to concerns from the Executive on financial risks and levels of funding, the Medical Independent (MI) can report.
The Minister made the request based on a draft version of the NSP. An amended version of the plan was subsequently approved and published in late March.
In correspondence seen by MI following a Freedom of Information request, Mr Ciarán Devane, Chair of the HSE board, sent a copy of the NSP to the Minister in November.
On 20 December, the Minister wrote back to Mr Devane seeking amendments to the plan regarding the mitigation of financial risk and expenditure control.
“It is acknowledged that the macro-economic environment is uncertain,” wrote Minister Donnelly. “In this context, in 2023, the HSE has received its largest ever allocation along with a once-off support fund in 2022 to offset some of the risks presented.”
The Minster noted that despite this level of funding, “the NSP sets out financial risk together with your [Mr Devane] cover letter that states: ‘Without appropriate additional funding support this will ultimately result in a significant financial deficit in 2023’.”
The Minister wrote that he did “not accept that this presentation of both the level of financial risk and certainty would be specified in the NSP without a focus on how the HSE proposes to mitigate any financial risks they have identified, or without the HSE setting out key expenditure management and control actions or tangible measures to improving spending efficiency.”
On 4 March, Mr Devane sent an amended NSP to the Minister. In his cover letter he wrote that a “significant amount of work has been completed to assess the level of financial issues and financial risks to be managed within our services in 2023”.
“We have set out our assessment of the magnitude of financial issues and risks in the plan, of up to 3.3 per cent of financial issues with an additional 6.8 per cent of financial and operational risks including Covid and demand-led services against our total non-capital budget of €21,688.6 million, as outlined in the financial management framework.”
Minister Donnelly approved the amended NSP in his reply on 16 March. However, he noted in his letter that “it remains a concern that the revised NSP continues to highlight a material level of financial risk for 2023”.
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