No extra money without reform, Taoiseach warns HSE

Taoiseach Leo Varadkar has warned the Health Service Executive it cannot continue to seek extra Government funding without reforms.

He told the Dáil on Tuesday that better management, proper clinical leadership, real accountability and proper responsibility were required from those charged with running and managing the State’s health service.

He said the HSE was unique in estimating it needed €1.5 billion extra every year to do nothing at all. “That is not sustainable,” he added.

He said if the health services were to be turned around and change implemented, the starting point could not be a 10 per cent increase in the budget.

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He said the changes and accountability required would be driven by the Government.

The Taoiseach was replying to Fianna Fáil leader Micheál Martin, who said revelations in The Irish Times on Monday that the HSE had warned about facing a financial shortfall of up to €881 million this year demonstrated a "very flawed and essentially opaque" approach to funding.

"At the very least, they show a very poor sticking plaster being applied," Mr Martin said.

He said there was a lack of transparency, substance and, “most worrying of all”, credibility surrounding the figures.

“There is a bogus, spurious element to some of them and, indeed, a clear statement in the correspondence that they will not translate into reality,’’ the Fianna Fáil leader added.

Top five spenders

He said pay agreements would absorb the bulk of the increased expenditure, meaning there would be little for additional services.

“The elderly will continue to suffer, the disabled will still be shortchanged in respect of access to therapies and services, the acute hospitals will remain under intense pressure, notwithstanding the experiences of December and January, and primary and community care will remain neglected,” added Mr Martin, a former minister for health. .

Mr Varadkar said this year the HSE and the health sector had the largest budget in the State’s history, at approximately €15 billion, an increase of €2 billion per year in the past three years.

“It is increasing much faster than the population is growing or ageing,’’ he added. “We are now one of the top five spenders on health in the world, if we divide the health budget by the number of citizens in the State, notwithstanding the fact we have a young population.’’

Mr Varadkar said even during the recession, health spending per capita was above average, so the idea Ireland was only catching up on underspending during the recession did not support the facts.

He said the fundamental problem and crisis affecting the health service was, in his view, not solely lack of money or resources.

“It is much more about how money is spent and how resources are deployed, and monetising all problems does not actually bring us any closer to a solution,’’ Mr Varadkar added.

He said there were already record numbers of doctors, almost 10,000, working in the public health service, while Ireland was very near the top of the league table in terms of nurses per head, per bed.