Underfunding and overspends in health drive Stephen Donnelly around the bend

Inside Politics: Children’s Hospital saga rolls on, while TDs don’t hold back in their support for Palestine


Good morning,

Minister for Health Stephen Donnelly will take to his feet in the Dáil chamber this afternoon with a tricky task on his hands.

After arguing behind closed doors for more than €2bn in extra funding for the health service, he instead received €800m during Budget 2024 talks. HSE chief Bernard Gloster warned last weekend that the health service is facing a shortfall in funding of up to €2.5 billion between this year and next year. In an effort to rein in costs, Mr Donnelly is expected to seek around €600m in savings or “efficiencies.”

Opposition parties have accused the Government of significantly underfunding the health service to such an extent that when combined with the recently announced recruitment freeze, a significant extra strain will likely become evident over the winter period. There has been a war of words within the Coalition over those tense budget talks. Donnelly is understood to have been left angry after hearing from other Ministers that his department’s overspend curtailed their chances of securing budget goodies. He has been privately accused by some within the Coalition of not having a feasible financial plan for his department, something which he has described as totally untrue to those around him.

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Fine Gael, on the other hand, are prickly about chatter that Minister for Public Expenditure Paschal Donohoe drove an overly hard bargain and they also outright reject any suggestion that he is to blame for health service underfunding.

Which brings us back to today. Having read about this war of attrition between Fine Gael and Fianna Fáil, the Opposition want answers. Donnelly will have to reassure patients that they are not in for a winter of misery, while also explaining where hundreds of millions of euro in savings will be made. He will have to defend his own Ministerial record while also admitting defeat in budget talks. Can he find a way to say that he wanted more, without implying that his Coalition colleagues wanted less for patients? We’ll find out when the debate starts at 1.44pm.

Children’s hospital saga rolls on

From a potential multi-billion euro underspend in the health budget, to an as-of-yet unquantifiable overspend on the national children’s hospital, Donnelly must be checking his lotto numbers in search of some luck.

The national children’s hospital has barely been out of the headlines for the last number of years. Prepare for more developments this morning when the Public Accounts Committee (PAC) hear from the various boards and organisations overseeing the development of the hospital.

Jack Horgan Jones has got an advanced steer on how the hearing will pan out.

He reports today that the timeline for completing the delayed hospital has slipped – again – with completion of the project now not expected until October next year.

The National Paediatric Hospital Development Board, which is responsible for stewarding the delivery of the project, will give a date of 29th October 2024. This is more than two years after the initially contracted date of August 2022. But that is not the actual date of the opening of the hospital, just when the building is completed.

As Horgan-Jones reports, it will take several more months to finish fitting out and commissioning, “raising the very real chance that no children will be treated in the hospital before the next general election, which must be held by March 2025.”

The big question for years has been: how much will it cost, when all the delays and legal costs and inflation are factored in?

Will it be over €2bn, as is widely expected?

Don’t expect an answer today, unless one of the representatives crack under questioning from politicians (highly unlikely).

The head of the board David Gunning won’t give an outline of the anticipated final cost of the project, despite an additional capital request being submitted to the HSE in May of this year. However, he will say that of the current overall capital budget of €1.433 billion, only €71 million is remaining.

It won’t be long, so, until Donnelly will have to bring a new memo to Cabinet looking for more money. And Ministers won’t want to grant an open-ended cheque. Sooner or later, the final figure will have to emerge.

The Government is highly sensitive about stories around the ballooning cost of the project - after all, it undermines their message of being a fiscally prudent Coalition.

We will cover the committee hearings over on www.irishtimes.com throughout the morning.

Best reads

We have a lot of coverage again, of course, of the Israel Hamas war.

Our lead story: Biden says Israel will allow humanitarian aid to cross from Egypt into southern Gaza.

Pat Leahy writes that were significant differences at times between Government speakers and opposition representatives during a debate in the Dáil last night on the conflict.

Joe Biden warns Israel against being consumed by rage.

Tánaiste announces additional €13m humanitarian aid funding for Palestinians, while, as Sarah Burns reports, a motion calling for an immediate humanitarian ceasefire in Gaza passed in the Dáil last night by a significant majority.

The Irish Times view on the EU and Israel/Gaza: who speaks for Europe?

Elsewhere, Irish Times books editor Martin Doyle has called to attention the scale of deaths during the Troubles by focusing on his own parish.

And in the US, Conservative Republican politician Jim Jordan has failed in a second attempt to be elected as speaker of the House of Representatives.

Playbook

Dáil Éireann

Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media Catherine Martin will take questions at 9am. Minister for Higher Education Simon Harris will then take questions on his brief afterwards.

Expect Leaders’ Questions at the normal time of noon, followed by questions on policy or legislation. As mentioned, there will be statements on the healthcare budget with Minister for Health Stephen Donnelly at 1.44pm, followed by statements on the importance of continued and enhanced Government capital support for sports facilities.

Topical Issues are up at 7.43pm. Green Party TD Francis Noel Duffy will bring his Defective Dwellings Bill 2021 during Private Members’ Business. The Bill would ensure builders and developers are held liable for their work.

Seanad

It’s a short but eventful day in the Seanad today.

After commencement matters at 9am, there will be statements on the situation in Israel and the occupied Palestinian Territory. The Seanad adjourns at noon.

Committees

It is also relatively quiet in the committee rooms.

As mentioned, the Committee on Public Accounts will hear from Children’s Health Ireland and the National Paediatric Hospital Development Board on the building of the national children’s hospital.

At 1:30pm, the Joint Committee on Housing will discuss the Citizens’ Assembly report on the directly elected Mayor of Dublin. Other committees meet in private. View the schedule here.