Patients face ‘clinical risks’ over shortfall, records reveal

The head of the HSE has privately warned the Government that patients will face clinical risks this year due to funding shortages for health services.

In a confidential letter sent to the secretary general of the Department of Health, HSE director general Tony O'Brien indicated the HSE received only half the additional money it sought to run health services during 2015.

He warned “it has not been possible to provide funding to address the substantial majority of the demographic and critical service cost pressures, some of which carry risks from a clinical perspective”.

Serious pressure

Among the areas where health services are under serious pressure are hospital emergency departments and maternity services, while there are also growing waiting lists for vital procedures and primary care.

Minister for Health Leo Varadkar and Mr O'Brien are likely to face questions about the contents of the letter at an Oireachtas committee meeting later on Thursday.

In his letter last November, Mr O’Brien also warned that “both the numbers waiting and waiting times will continue to increase” under the Fair Deal nursing home scheme.

At the time of the letter, more than 2,000 people were waiting up to 15 weeks for funding for a nursing home bed.

The HSE, the Department of Health and the Department of Public Expenditure have all repeatedly refused to release details of the submissions made by the health service in the financial estimates process last autumn.

Likely impact

However, the correspondence shows for the first time the likely impact of the financial shortfall on health services this year.

In the letter sent to the Department of Health on November 18th last, Mr O’Brien confirmed he had sought an additional €1.4 billion in funding as part of the negotiations leading up to the budget.

He acknowledged that the final allocation - €625 million - was the best that could be secured in a single year. Over €500 million of this will be taken up by last year’s financial deficit, resulting in a net increase of about 1 per cent in the budget.

“In addition to the general issues around service pressures and system/data constraints, there is a particular challenge in relation to medical agency given the various issues around recruitment and retention at both consultant and non-consultant hospital doctor level,” he wrote.

'Insufficient funding'

Mr O’Brien also said there was insufficient funding for the cost of incremental pay rises for staff and other pay issues. These alone were likely to cost €36 million.

The Department of Health is expected to tell the Oireachtas health committee on Thursday that it is making progress in a range of areas, despite the cost pressures.

In the area of nursing home care, it will say the number of applicants waiting for funding has fallen to 1,196 and waiting times are down to 11 weeks.