Half of HSE regions have ‘eaten into’ next year’s budget due to overruns, Minister says

Half of the Health Service Executive (HSE) regions have already “eaten into” next year’s budget allocation due to over-recruitment and financial overruns, the Minister for Health has said.Budget 2027 announced a record €29.1 billion in funding for next year, of which €1.72 billion is for capital investment.This year marked the first year that funding has been devolved into six regions, a key pillar of Sláintecare, the health service reform plan.However, the health service has been under significant financial pressure in recent months, with the financial deficit being forecast to hit €1 billion by the end of the year. READ MOREConsequently, in September, four of the regionswere stripped of their powers over day-to-day spending.Speaking at a press conference on Wednesday about her department’s budget allocation, Jennifer Carroll MacNeill said steps are being taken to prevent the overruns from reaching the billion figure.The deficit for the end of September was €781 million, the Minister said, adding that there are two contributing factors, namely pay and medicines.“There are two breakdowns on it. There is an area that we should be in control of, which is the pay budget. We have had a very significant uplift in resources,” she said.[ Free contraception for women under 37 and homecare hours boost: Inside Budget 2027’s health packageOpens in new window ]“There was provision for 3,300 people on average salaries to be recruited in the second half of 2026 – contingent on reducing overtime and agency spend. Unfortunately, 3,600 people were recruited in the first half of the year without the commensurate and necessary reduction in agency and overtime.”Carroll MacNeill said four of the six regions breached their pay budget by more than two per cent, though she acknowledged the West-North West region has made improvements and could bring it under this level by the end of the year.“That’s not acceptable. That has to be reined in. If you’ve overrecruited this year, you’ve eaten into next year. This is about workforce planning. This is a test for management of the different regions that if you are given a budget by the taxpayers and patients of Ireland to recruit in strategic ways, you cannot do everything every single year,” she said.“Within the first year of this regionally-funded structure, we have two regions that have performed very well, one that could come to below two per cent and three others that very clearly have eaten into next year’s provision.”The Minister said the rising cost of drugs is an “expensive success story” and one which is “not part of the budget we can control”. “There are no circumstances in which I would see the supplementary [additional budget] for a pay budget that hasn’t been managed, but we agree the cost of funding medicines is so very important and we will look at that as the year goes on.”[ ‘I was shocked by it because of the spin beforehand’: How a healthcare worker, engineer and student view Budget 2027Opens in new window ]Meanwhile, Carroll MacNeill said a shingles vaccination programme is expected to start next June on a phased basis, starting with older people who are immunocompromised before gradually expanding to all over 65s.There will also be a focus on recruiting into community services, rather than acute hospitals, and the State’s drugs budget will increase by €324 million to more than €4 billion next yearIn mental health, Minister of State Mary Butler announced four new Jigsaw youth mental health services, two additional crisis resolution teams, six crisis cafes and 40 additional clinicians for a new ADHD pathway and enhanced intellectual disability capacity in the Child and Adolescent Mental Health Services (Camhs).