One of the most-commented aspects of the recent Budget 2013 announcements was the absence of solid detail in support of the savings and cuts in the health budget in 2013 and given the experience of budget overruns and sub-par performance by Minister for Health James Reilly in 2012, there has been considerable concern that the savings and cuts were not achievable in 2013, and as they amounted to €781m for 2013 alone and €1,173m in 2014, that’s a concern.
In the Dail this week, the Sinn Fein finance spokesperson Pearse Doherty quizzed the public expenditure and reform minister, the health minister and his junior minister, about the detail of the savings and cuts. Although some further detail was forthcoming, the responses don’t fill you with confidence that the Minister is across the challenges that now confront him, and which he singularly failed to meet in 2012.
We don’t learn very much save there will be further workplace change and savings which will be agreed with unions and there will be €120m of savings from a new agreement with drug suppliers.
The profiling of savings by month in 2013 should be available in February 2012, and these will be carefully studied to see if health savings are being backloaded, and health is set to be the Departmental budget that will be most closely scrutinised with the publication of monthly Exchequer Statements in 2013. It is a disgrace that in 2012, the capital budget was cynically cut back to compensate for overruns in the Department of Health – if we had been spending our capital budget, which remember was reduced in the December 2012 budget, then we would have had 4-7,000 extra people employed in the economy this Christmas.
The parliamentary questions and responses are here:
Deputy Pearse Doherty: provide an analysis of the €308 million of pay related savings in his Department’s budget in 2013; and if he will set out the way such savings estimates were validated by his Department.
Minister for Health, James Reilly: A total of €308m in pay-related savings has been targeted for the health services in 2013. These savings will be achieved under three separate headings: firstly, by intensifying the implementation of the Public Service Agreement within the health services, secondly, through the negotiation of an agreement on further workplace change and savings with public sector unions, as has been proposed by Government, and thirdly, through further reductions in staffing in 2013.
Required measures under the PSA and included in the recently-revised sectorial plan for Health include new rosters in hospitals, changes in skill mix in nursing homes, the implementation of the recent agreement reached with Hospital Consultants, a significant reduction in overtime and agency spending and a reduction in management grades.
The Government has initiated discussions with the Trade Unions on a new agenda for improvements in the productivity of public servants and reductions in the cost of delivery of public services. Detailed engagement is expected to commence early in 2013, under the leadership of the Department of Public Expenditure and Reform.
Implementation of the PSA is overseen by the national-level Implementation Body. Each sector is required to provide periodic reports to the Implementation Body and this arrangement will continue in respect of measures to be implemented in 2013.
Deputy Pearse Doherty: provide the underlying workings in support of the €60 million savings on Department vote in his Department’s 2013 budget; and if he will set out the way such savings estimates were validated by his Department.
Minister for Health, James Reilly: The adjustments to the Department of Health Vote, Vote 38, are set out in the Budget book published recently and available on the website of the Department of Public Expenditure and Reform.
The Department of Health Vote is being reduced by €90m. This arises from a range of measures. Even allowing for additional expenditure related to the EU Presidency, there will be a reduction in the Department’s Administrative Budget. There will be savings on the National Treatment Purchase Fund and €25m of its budget will be transferred to the HSE for use in an Intervention Fund. There will also be a range of further reductions, including a reduction in funding to health agencies.
Deputy Pearse Doherty: if he will provide the underlying workings in support of the €70 million reduced professional fees in the Department of Health 2013 budget; and if he will set out the way such savings estimates were validated by his Department.
Minister for Public Expenditure and Reform, Brendan Howlin: I refer the Deputy to the Minister for Heath who has responsibility for achieving the €70m savings target set by Government in the estimates by way of a reduction in professional fees.
It is matter for the Minister for Health to determine by regulation the appropriate level of reduction in professional fees for the different health professionals having regard to the state of the public finances and the other factors set out in Section 9 of the Financial Emergency Measures in the Public Interest Act 2009 following a 30 day consultation process with the relevant interests.
Deputy Pearse Doherty: provide the underlying workings in support of the €160 million reduction in cost of drugs and other prescribed items in his Department budget for 2013; and if he will set out the way such savings estimates were validated by his Department.
Minister of State at the Department of Health, Alex White: Due to the very difficult and challenging economic environment, the Government has committed to achieving additional savings of €160 in expenditure on drugs and medicines in 2013 as set out in the following table:
IPHA/APMI Agreement on Drug Price Reductions
|Quality Prescribing Initiative||
|Reduce price of oral nutritional supplements||
|Delisting products from GMS scheme||