‘Savings and efficiencies’ needed in health budget, senior officials acknowledge

Productivity gains are needed in health service, says Department of Health secretary general Robert Watt

“Savings and efficiencies”, including restrictions on recruitment, overtime and the use of agency workers, will be required to control the health budget, top civil servant Robert Watt will tell TDs and senators on Tuesday.

Mr Watt, who is the secretary general of the Department of Health, will also tell the Oireachtas Committee on Health that “major gains in output and productivity” will be required in the health service in the coming years.

He will also say that the growth in the cost of medicines is “not sustainable” and acknowledge that “forecasts of health expenditure need to improve as does control of expenditure”.

The Government is to face further questions about its provision for next year’s health budget in the Oireachtas on Tuesday as members of the Oireachtas health committee quiz senior officials from the Department of Health and the Health Service Executive, and Sinn Féin tables a motion in the Dáil for debate in the evening.


Mr Watt and HSE chief executive Bernard Gloster are among the senior officials due to attend at the Oireachtas health committee on Tuesday.

The Government has been under pressure on the health budget since it emerged in the immediate aftermath of the budget announcements that the Department of Health had been allocated far less than it sought.

Mr Gloster has repeatedly said that the HSE will not have enough money next year to provide the current level of health services due to the costs associated with inflation and additional demand.

Minister for Health Stephen Donnelly has said that he expects that a supplementary estimate – a funding top-up later in the year – will be needed next year, on top of the allocated budget.

The HSE is on course for an overspend of about €1.5 billion this year, which will require a supplementary estimate later this year.

Mr Gloster will tell the committee that the HSE will stick to clear targets on spending and recruitment next year in the context of a “very constrained and challenging financial position”.

Mr Gloster will say that the planned recruitment of an additional 2,200 staff in 2024 – a third of this year’s allocation – will cover “many of the essential areas of service to be continued”.

There will “in the main” be no growth in national strategies and programmes – for areas such as maternity, cancer and trauma care – but “there is a significant amount of work that can be done with the existing resources within these programmes”.

In his opening statement, Mr Gloster will say that 2024 will see a focus “on consolidation more so than growth”, but that “services will continue”.

The HSE’s position has not changed since he said earlier this month that the funding allocated to it in Budget 2024 was “not adequate”, and any supplementary allocation in respect of 2023 and the possible implications of that for 2024 “remain to be decided”.

“Until such time as the HSE receives the letter of determination (from Minister for Health Stephen Donnelly), we are not in a position to elaborate further on the 2024 outlook.

“It is my intention for 2024 that budget holding areas will have a full pay and numbers strategy and allocation within which to work and within which the targets will be very clear.

“An improved control environment will allow for these targets to be met and maintained on the one hand but not exceeded on the other. This will require a particular co-ordinated focus on existing staff, the management of new posts, the management of the use of agency and overtime and conversion from agency staff to direct employment, where appropriate and possible.”

Sinn Féin health spokesman David Cullinane accused the Government of “throwing in the towel” on the health service.

“If this decision is not reversed it will have a devastating effect on hospitals and health services right across the State,” he said.

“The consequences if they fail to do so will be felt widely across all services. The crisis in emergency departments will deepen. Patients will continue to languish on trolleys.

“There will be setbacks across mental health, disabilities and in key clinical strategies such as cancer, cardiovascular and maternity care. There will be no new money for patients in need of new medicines which become available next year.”

Pat Leahy

Pat Leahy

Pat Leahy is Political Editor of The Irish Times

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times