The HSE is under significant financial pressure. At the end of August, its cash deficit had reached €696 million. While there are real and growing pressures across the health service, including demand, demographic change and rising medicine and treatment costs, these do not fully explain the scale of the current overspend.
The issue is that expenditure is rising faster than the additional funding provided and faster than activity growth in key areas. The HSE already has controls in place, including formal financial escalation across all six Health Regions, HSE CEO approval of key spending decisions, and regional controls on agency and other expenditure.
However, progress has not been sufficient or consistent, and the Department of Health is working with the HSE and the Department of Public Expenditure and Reform on what further controls may now be necessary. The purpose of any control measures is to protect essential care, strengthen prioritisation, and ensure that funding, staffing and services are directed to the areas of greatest need and greatest patient benefit.