Health service not underfunded, head of Department of Public Expenditure tells TDs

There is no underfunding of the health service, according to the head of the Department of Public Expenditure.

Ireland’s health service is one of the best funded in Europe, with spending relative to national income 20 per cent above average, department secretary general David Moloney told TDs on Tuesday.

Health spending has increased by €7.4 billion and an additional 22,000 staff have been recruited since 2019, Mr Moloney said, addressing the Oireachtas committee on finance, public expenditure and reform, and Taoiseach.

Mr Moloney was being questioned by TDs over the difference between his department on the one hand, and the Department of Health and HSE on the other, regarding the amount of money needed to run the health service.

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The Department of Health sought an additional €2 billion to fund existing levels of service in Budget 2024, but received only €708 million, plus an additional €100 million for new developments.

HSE chief executive Bernard Gloster has said the funding allocated to health is “inadequate”. He has also warned, in a letter to Minister for Health Stephen Donnelly, of “significant and punitive risks to the public” if the HSE is forced to implement cost controls to reduce its budget deficit next year.

Sinn Féin finance spokesman Pearse Doherty pointed out that the Department of Health’s “ask” was three times what it received. No other department would have experienced such a gap between what it said it needed and what it got, he said.

Asked how big a supplementary budget health will be needed before the end of the year, Mr Moloney said negotiations on this were well advanced and a proposal is likely to go to Government next week.

In relation to forecasts that a €1.5 billion supplementary budget will be required, he said the Department of Health’s initial proposal was “not at that level”.

Mr Moloney, asked by Fine Gael TD Bernard Durkan why the provision of health was more expensive in Ireland, said we live in a “high-cost” country where pay rates compare favourably with other locations.

He said robust financial systems on health expenditure needed to be re-established after the Covid-19 pandemic, when they weren’t “foremost”.

Sinn Féin Senator Rose Conway-Walsh questioned the basis of international comparisons on health spending, saying Ireland’s figures included expenditure on private health and also on social care, which was not included in other countries’ figures.

Aontú leader Peadar Tóibín meanwhile, questioned the lack of comparative information internationally on productivity in the health service.