HSE Service plan 2016

HSE’s 2016 Service plan has just been published. I was on RTE’s Drivetime talking to Mary Wilson about it on Thursday night. It’s a long document, at 178 pages, with more detail and more useful information than previous plans. If you work in health, it’s worth looking at the pieces directly relevant to yourself and your patients.

The high level message is an 0.8% increase on the (expected) 2015 spend, or 6.7% on the 2015 budget. The good part is that talk from DPER about bringing the 2015 deficit forward into 2016, which would have led to a 5% cut in expenditure, has gone away. The bad news is that HSE probably needs a minimum of €300 million extra (that is above the 2015 spend, not the 2015 budget) in 2016, just to stand still, and it’s not getting it. The 2015 service plan took a similar approach to the budget, and 2015 was definitely easier than 2014. The acute hospital sector may have the greatest difficulty with a budget €83m less than they have spent in 2015. There is a lot of language about ‘significant financial challenges’ and ‘financial risk’, which is likely to be prophetic.

None of this was unexpected. HSE had suggested an extra €2 billion in budget, or about €1.4 billion in health service spend this year, which was never going to happen. The Irish budget is still very constrained by our commitments to the EU. These commitments may, or may not, be sensible (see a report from Brookings), but Ireland can do little to change them unilaterally.
Continue reading

High salaries and public trust

The size of the salaries of senior trade union officials has hit the news in Ireland recently. As I write this, Eddie Downey, former president of the IFA, and a decent and honest man, is on the radio explaining the severance package of the IFA’s general secretary. At the same time as the IFA, and its members, face big challenges like climate change, falling commodity prices, and plans to increase dairy production, the organisation is consumed with a row about salaries. It appears that Eddie Downey was getting about €147,000 + benefits, and the secretary-general about €450,000. These salaries were not widely known to the members of the organisation, and when these became public knowledge there was an enormous row.

At the same time the secretary-general of the INMO,  Liam Doran, a notably effective trade union official, is refusing to comment on his salary. As his members move towards strike action next week, the media are looking to see how much he is paid. He’s not telling. He should!
Continue reading