The Health Service Executive has recorded a financial deficit of over €270 million in the first seven months of the year, according to its latest performance report.
Sustained pressures on hospitals, caused by the challenge of high trolley numbers and “excessive” inpatient and outpatient waiting lists, have largely prevented any increase in bed funding, the report for July states.
Staffing levels and pay costs in some hospitals have increased as a result of the difficulties in sourcing medical and nursing staff, the European Working Time Directive for doctors, and the knock-on impact of reports such as that into the maternity services at Portlaoise hospital.
About €122 million of the overrun relates to the primary care reimbursement service, local health schemes, costs associated with the State Claims Agency, overseas treatments and pensions.
The rest was incurred in core services such as acute hospitals (€112 million over budget) and social care (€24 million).
While the overall deficit at the end of the year looks set to top €500 million, the HSE says it expected most of its divisions to be close to break-even by December, although in mental health and primary care this will involve once-off measures that will not be sustainable next year.
Acute hospitals
The exceptions are acute hospitals, where the end-of-year deficit is expected to be up to €150 million, and social care, which is forecast to exceed its budget by €37 million.
One positive trend is a reduction in spending on agency staff, which is expected to drop €25 million on last year.
Costs are falling in most hospitals, but “exceptional difficulties” in recruiting staff in five hospitals will see their spending increase by a cumulative €10 million.
The report says significant improvements have been made in cutting waiting lists, with 607 adults waiting longer than 18 months for inpatient or daycase treatment, and 10,162 people waiting for an outpatient appointment. These figures have worsened somewhat since July.
The absenteeism rate in July, at 3.95 per cent, is the lowest recorded for this month.
Minister for Health Leo Varadkar said the report showed increased activity and some improvements, "although challenges remain". Delayed discharges were at their lowest level for many years, he pointed out, and more patients were being seen.
However, long waiting times for scheduled or elective procedures continued to be of concern.
