The Government must either revise the budget allocation to the health service or own the “catastrophic consequences” of “deliberately underfunding” the sector, Sinn Féin has warned.
Party health spokesman David Cullinane was responding to public expenditure minister Paschal Donohoe’s insistence that the €22.5 million envelope allocated to the Department of Health in Budget 2024 will not be revisited.
HSE chief executive Bernard Gloster has warned that the amount is not adequate to run the health service at the same levels as this year.
The Department of Health is already facing an overspend of around €1.5 billion this year – an overrun that will require a supplementary estimate allocation for 2023.
Mr Gloster told senior management on Friday that he was extending an existing recruitment pause beyond clerical and management grades to include patient and client care roles.
He also announced an immediate pause on around 7,000 posts, previously approved in principle, which can now not be funded.
Representatives of healthcare workers have sharply criticised the freeze, and opposition politicians have called on the budget for the Department of Health to be re-examined.
Defending the allocation, Mr Donohoe said Ireland spends more of its national income on health than most EU member states, highlighting that the department received an additional €1.1 billion for current expenditure.
However, Mr Cullinane claimed there had been an “intentional decision” by the three coalition leaders to “chronically underfund the health service”.
“What we’re now seeing is a muddying of the waters and this narrative that this money can be saved through efficiencies,” he told reporters outside Leinster House.
“And it’s laughable coming from the Fine Gael party who’ve been in government for 13 years, who didn’t deal with the runaway spend on agency spend, management consultancy, they didn’t make the reforms in healthcare which were necessary to achieve savings.
“And now at the 11th hour, because of this crisis, they’re now talking about more efficiencies in healthcare. They had their opportunities for 13 years, and they didn’t take them.”
Mr Cullinane said, at most, efficiencies could generate a further €400 million. He said that would still leave a “big black hole” in next year’s health budget.
“The consequences of that will be felt very deeply,” he said.
He added: “So it’s a very real crisis for the Government, it’s an even bigger crisis for patients and those who work on the front line. We have a government that intentionally, deliberately, purposely underfunded the health service with the catastrophic consequences that will have for patient care.
“So if they want to avoid a disaster or crisis in health care, then the only way to do that now is to properly fund the health service and to give the health service more money for next year. And that will have to be done.
“If they don’t do it, then they will have to own the consequences of that, which includes having an impact on patient safety, services right across healthcare from disabilities, mental health, in our hospitals and primary community care.”
Labour health spokesman Duncan Smith claimed Mr Donohoe was “calling the shots” in the health service.
Reacting to Mr Donohoe’s comments that there was no proposal to revise the budget allocation, Mr Smith said: “It’s been an absolutely incredible week and not for the good.
“We have the chief executive of the HSE (Bernard Gloster) saying he won’t have enough money to run the health service. We have the Minister for Health (Stephen Donnelly) failing to deliver on a whole host of areas both within the health service and on the top line figure of overall funding.
“It’s an incredible situation.”
He claimed Mr Donohoe was “doubling down” on a position of not reopening the budget.
“I think it’s going to send further shockwaves of worry through our health service,” he told reporters outside the Dáil.
“The fact that Paschal Donohoe has taken such a hard line would indicate to us that he’s calling the shots in our health service going into 2024. And, quite frankly, that’s just not good enough.”
Commenting on the health allocation, Mr Donohoe said: “The budget agreed last week by Government, set out an allocation of €22.5 billion (current and capital) in 2024 for health. This is an increase of 1.1bn euro current expenditure on last year’s budget allocation.
“As the Minister set out in his Budget Day speech, Ireland spends more of its national income on health than most EU member states, and this expenditure occurs with a younger population than many comparable member states.
“The budget allocation also included a Health Resilience Fund, which will fund the post-pandemic escalation in demand and activity across our acute hospitals, and a programme of initiatives to improve financial oversight.
“There is no proposal to reopen the Government-agreed budget allocations.
“The details of supplementary estimates will be considered as more financial information is available towards the end of the year.”
