The Health Service Executive’s financial deficit more than doubled to €54.755 million between January and February this year, a new official report has shown.
The report, published by the HSE, also warns that the health service is facing significant financial challenges in the months ahead.
It forecasts, for example, that on current trends that various primary care schemes could face a deficit of €40 million by the end of the year. It says to to the end of February there had been an overrun of more than €6 million in this area and highlights deficits particularly in the hardship medicine scheme and the drug refund scheme.
The report says that the bulk of the deficit recorded to the end of February - €39.5 million - arose in the acute hospital sector.
The report particularly points to overruns in hospitals in the West/North West of nearly €9 million, and in Limerick. It says the University Hospital Limerick recorded a deficit of €4.1 million to the end of February.
"Hospitals in the West/North West and the University of Limerick hospital group continue to report material deviations from their respective year to date budgets. Pay expenditure is over budget in both hospital groups mainly as a result of agency costs relating to non consultant hospital doctors (NCHDs).
“The University of Limerick hospital group have reported an adverse income variance which is attributable to maintenance charges. In addition there was also an adverse income variance in the West/North West hospital group which is attributable to in-patient charges.”
The report maintains that increased spending on non-consultant doctors provided through agencies is one of the main cost drivers facing the HSE.
“There is a continued upward trend in agency costs in relation to non-consultant hospital doctors. The year to date February expenditure on agency doctors was €16.17 million versus €7.43 million for the corresponding period in 2013.”
The HSE report warns that the health service faces a challenge in delivering the scheduled saving of €23 million this year arising from probity measures being taken in relation to medical cards - the assessment on whether patients with medical cards are actually within the relevant income criteria.
The report also says the HSE had a target of securing €50 million in savings under the initiaitve to introduce reference pricing for drugs. However it maintains “this is dependent on the pharmaceutical industry supplying drugs at the reference price.”
“The programme for free GP care will commence this year. However, it requires legislation and will not be operational on a full year basis in 2014. The total estimated challenge in this regard is €35 million. This programme will deliver savings in 2014.”
The report also warns that the the extent to which anticipated savings under the Haddington Road agreement on pay and productivity cannot be achieved in 2014 represents “ a key financial risk to the organisation”.
