The Government is insisting that controlling the number of staff employed in the HSE is a key element in tackling rising healthcare spending.
Nurses on Tuesday strongly criticised recruitment restrictions put in place in the HSE, which they said were placing patients at risk.
The Irish Nurses and Midwives Organisation (INMO) maintained that at least 325 staff nurse roles and more than 100 staff midwife roles were unfilled due to the employment restrictions.
The INMO argued,for example, that there will be no nursing staff in Wexford to provide childhood immunisations from September.
However, Minister for Finance and Public Expenditure Paschal Donohoe said sticking to agreed staffing levels in the health service was vital to ensuring that budgets are not exceeded again.
Separately, a confidential report given by HSE chief executive Paul Reid to the organisation's new board in recent weeks said in June it had 1,030 more staff than officially permitted.
‘Control measures’
He said “control measures” had been put in place to ensure a break-even position was reached by the end of the year.
Mr Reid said the HSE’s target was to confine financial deficits in the acute hospital and disability sectors to less than €100 million.
He also revealed that as a result of overspending in 2018, the HSE had to face a “first charge” of €150 million on expenditure this year.
INMO general secretary Phil Ní Sheaghdha said: “The recruitment ban in nursing and midwifery has got to go. Patients are being put at extreme risk, with essential services being taken from the most vulnerable. Before the ban, we had understaffing and overcrowding. Refusing to fill vacant posts is adding fuel to the flames.”
However, senior health sources said that recruitment controls applied earlier this year were the primary reason why health budgets had not so far overrun in the same way as they did last year.
Most of the issue of controlling expenditure revolves around the health service, which has shattered its budget ceilings in recent years
Mr Reid told his board that the HSE had recorded a deficit of €116 million to the end of April. He said in the same period last year the overrun was €177 million.
Expenditure report
Ministers will discuss expenditure issues at Wednesday morning’s Cabinet meeting, when Mr Donohoe circulates the mid-year expenditure report. Political sources say that most of the issue of controlling expenditure revolves around the health service, which has shattered its budget ceilings in recent years, and required a bailout at the end of each year.
On Tuesday, Mr Donohoe said he met with Minister for Health Simon Harris on that morning and discussed health expenditure.
“There’s nothing at all inevitable about the health service needing a large supplementary estimate for this year, and I’m absolutely determined, as he is, that our management of health expenditure for 2019 is in a far better place than it ended up in the second half of last year,” Mr Donohoe said.
“The key issue for me is ensuring that the staffing plans that we have included in the HSE service action plan are delivered,” he said.
Mr Donohoe said that recruitment which was not funded or agreed was the key driver of overspending in the past.
