Expenditure: The Eastern Regional Health Authority, which funds services in the Dublin, Wicklow and Kildare areas, is forecasting a financial overrun of around €25 million this year. Martin Wall reports.
The Irish Times understands that, in a financial commentary submitted to the Department of Health at the end of September, the ERHA warned that its financial state of affairs could worsen if the trend continued in escalating expenditure on demand-led schemes, such as the drug payment schemes, the hardship medicine scheme, the dental treatment scheme and the long-term illness scheme.
"We continue to hold the view that the position emerging for the full year is a deficit in the order of €25 million for the region, depending on the effect of timing developments. If the current expenditure trend on demand-led schemes continues, there would be a further shortfall of up to €12.2 million based on August data," the ERHA told the Department of Health.
The health authority also revealed that the main teaching hospitals in the Dublin area had a collective deficit for the first eight months of the year of €17.1 million. This, however, represented an improvement in their financial books over the period for the first seven months of this year when a €20 million overrun was forecast.
The ERHA report revealed that the three health boards in the eastern region - the Northern Area Health Board, the South West Area Health Board and the East Coast Area Health Board - were showing a combined financial deficit of €14.9 million for the first eight months of 2004.
The ERHA said that expenditure on the demand-led schemes continued to be a dominant pressure within the Area Health Boards.
"Substantial growth in the Drug Payment Scheme, Hardship Medicines, Dental Treatment Services Scheme and Long-Term Illness Schemes have contributed to the overall growth within demand-led schemes," the authority stated.
The ERHA argued that rising drug costs, including the cost of dispensing and treating long-term conditions such as diabetes and other serious illnesses, was one of the main factors of driving up the bill for the demand-led schemes.
Other reasons for the escalating costs were increased claims under the Drug Payment Scheme, the wider availability of medicines under the hardship schemes and the greater mark-up for pharmacists for drugs dispensed outside of the medical card scheme.
"Based on a year-to-date expenditure of €180.04 million on all demand-led schemes, including DTSS and ophthalmic, would equate to a full year expenditure of €267.8 million. Comparing this to a budget figure of €240.6 million, this would represent a potential shortfall of €27.2 million for the year compared to an original projected shortfall of €15 million," the report stated.