Dáil Éireann Debate, Tuesday - 24 February 2026
1029. Deputy Ken O'Flynn asked the Minister for Health whether her Department has assessed whether the absence of programme-level expenditure analysis for high-prevalence chronic conditions, including chronic pain, is consistent with public financial management standards and performance-based budgeting principles; whether any review of this matter has been undertaken since 2020; and if she will make a statement on the matter. [14710/26]
Amharc ar fhreagraFunding for chronic conditions forms part of the wider HSE budget for acute and community services. Since the establishment of the HSE Health Regions, the allocation of funding for individual service areas, including chronic conditions, is now made at regional level. This reflects the broader move towards devolved decision-making under Sláintecare, enabling Health Regions to prioritise resources in line with local population needs and service configurations. This approach is consistent with the shift to regional autonomy and was approved and communicated to the HSE in the Letter of Determination for 2026, which issued to the HSE in October 2025.
The Department does not monitor HSE expenditure at the level of individual disease or conditions, including high-prevalence chronic conditions. This is not a gap in financial oversight; it reflects how health services are organised, delivered and financed. Services are funded and managed on an integrated care basis rather than through separate disease-specific budget lines. Extracting a single disease-specific expenditure figure would not reflect how the Irish health service, or indeed any modern integrated system, is organised. Budgets, staffing and accountability are aligned to services and care pathways, not to individual diagnoses.
Performance monitoring and Equity of access across Health Regions takes place under the HSE Performance and Accountability Framework, with the Department monitoring HSE delivery against the National Service Plan, identifying variation between regions, ensuring consistency of service provision, and intervening where necessary to address access issues.
