HSE indicates reforms under Croke Park agreement went backwards this year

Department of Public Expenditure publicly rebukes HSE management

Details of the New HSE Governance Structure being unveiled by  Minister for Health Dr James Reilly last year. Photograph: Eric Luke
Details of the New HSE Governance Structure being unveiled by Minister for Health Dr James Reilly last year. Photograph: Eric Luke


The HSE has become the first public body to state that the pace of reforms delivered under the Croke Park agreement effectively went backwards in the first part of the year.

The health authority argued in its most recent performance report, published yesterday, that this contributed to its financial difficulties which has left it facing a potential deficit of about €200 million for the year.

The HSE, in the report, also confirmed for the first time that it will not be able to deliver about one-third of the €150 million in savings that it had been expected to generate this year under the Haddington Road deal. It said this was due primarily to time delays in implementing the accord.

The official position of the Government and many trade unions has been that the Croke Park agreement on public service pay and reform, which was in place until it was succeeded by the Haddington Road agreement in July, has delivered hundreds of millions of euro in savings.

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However, in the performance report for July, the HSE says that “our regions are reporting that in the year to date we have experienced a reduction in the pace and/or availability of flexibility under the original Public Service (Croke Park) agreement. The assessment is that this has already contributed to slippage on our cost-containment programmes.”

The HSE report stated that based on figures for seven months of the year it was projecting a shortfall of €107 million in its direct services, which includes a projected deficit of €75 million in hospital services.

In the community area – mainly the demand-led medical card and other drug schemes – the HSE is forecasting a deficit of a minimum of €65 million but no more than €100 million.

The HSE no longer provides a projection of its total deficit but divides this up between a number of contributing areas.


Criticism
Last night the Department of Public Expenditure and Reform openly criticised health service management. "If the HSE are reporting slippage or inability to deliver savings, it is because HSE and local health management are failing to deliver on the potential of both Croke Park and Haddington Road. The pace of reform is set by management, not by unions," it said.

Meanwhile the HSE report also showed that more than 190,000 fewer medical cards than anticipated had been issued so far this year. By the end of July, 1,866 million cards had been issued, a small increase on the 1.853 million at the start of the year but almost 3 per cent below target.

The number of discretionary medical cards fell from 63,000 to 54,000. The HSE projected a doubling of the 131,000 GP visit cards issued this year but by the end of July the number had fallen to 125,000.

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.