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budget 2024

Govt walking into trouble with warnings health system underfunding will have 'freeze effect'

Pearse Doherty said today the repercussions of the lack of funding in the budget will be seen “in the weeks and days to come”.

THE COALITION LEADERS have been at pains to state publicly that the number one focus of this government is on housing. 

There’s nothing wrong with that prioritisation. 

With 11,000 people in emergency accommodation across the country last month – the highest number ever recorded – it is right and proper that the kitchen sink be thrown at the housing crisis. 

However, Ireland’s health service is another area where the focus cannot slip.

This year’s budget is only dedicating €100 million to new measures, down from €250 million in the last budget. The overall health budget stands at €22.5 billion. It’s not difficult to work out that we’re going to run into problems in 2024.

Looking at the overall health budget, there is no new funding for new medicines this year, with Health Minister Stephen Donnelly instead telling reporters yesterday that cost-saving measures will be explored by talking to big pharma and using generics drugs, where possible.

Turning to the issue of mental health, something the government said it was keen to invest in given the strain on people post-Covid, Budget 2024 only commits to giving €13-€14 million for new measures. (The overall mental health budget is almost €1.3 billion)

Minister of State Mary Butler with responsibility for Mental Health and Older People, confirmed to The Journal yesterday that she has no new funding for a number of services the government had promised to expand, such as the adult ADHD services, which was first launched just two years ago. 

Fiona Coyle, CEO, Mental Health Reform said the lack of new funding will threaten the viability of mental health services in 2024.

“We believe that cost overruns in the health budget have jeopardised funding for new mental health services. While we acknowledge the increasing demands on the health system, it is short-sighted and irresponsible to divert vital funding from mental health,” she said. 

Coyle explained that the development of new measures is essential to provide critical services to children and young people, as well people with complex mental health difficulties and priority groups.

The budget will have a “freezing effect on the mental health system” as many services will be forced to stagnate with no potential for expansion, said Coyle. 

irish-budget-2024 Minister of State Mary Butler at yesterday's post-budget press conference. Brian Lawless Brian Lawless

While she welcomed the allocation of 68 new posts for Child and Adolescent Mental Health Services (CAMHS), calling it significant, Coyle said it is not enough to address the broader issues in youth mental health. 

Giving what she said was an “honest answer”, Butler said yesterday that she had to work with the resources she was allocated, admitting that she was disappointed in the lack of new measures she can roll out next year due to budgetary issues.

It is clear that the overruns from acute hospital settings has eaten into Butler’s budget.

Acknowledging the health budget’s limitations on new spending, Donnelly candidly acknowledged during yesterday’s press conference that next year’s focus is on maintaining the services we already have.

In other words, we have the money to keep the service that is creaking at the seams going, just about, but no new substantial cash for improvements.

The latest reason the health service is facing into this void is he €1 billion-plus overrun in the health budget, something that has brought Donnelly’s leadership into question, according to Sinn Féin’s health spokesperson David Cullinane. 

taoiseach-leo-varadkar-officially-opens-new-wing-at-the-mater-hospital PA PA

The Public Expenditure Minister Paschal Donohoe told The Journal this week in a post-budget interview that they are yet to understand the final figure on the overrun, such is mangled state that financial data is correlated in the health system.

Leaders’ Questions

In a turn up for the books, Sinn Féin’s Pearse Doherty appeared to almost come to the defence of Donnelly today, telling the Dáil the health minister has been “hung out to dry” by his government colleagues by only giving him €708 million to maintain existing health services, something he said even the HSE itself doesn’t think is enough to stand still.

“When things get bad in hospitals this winter… Remember why this is happening,” Doherty told Tánaiste Micheal Martin.

Martin said he did not agree with Doherty’s “assessment” of the government’s commitment to the health system, stating that the government has added over €7 billion to the service for next year. 

The Tánaiste says the investment has helped to employ over 22,000 since 2020 and increase the number of beds in both hospital wards and ICU. “Our outcomes clearly show that our health service is delivering quality of care across hospitals all over the country,” he said. 

Doherty then asked: “Tánaiste what land are you living in?” “Walk into any of our hospitals, any day of the week, any week of the year, you will see patients on trolleys or in chairs that have been admitted to hospital but can’t get into a bed. Why? Because the beds don’t exist.”

“Your own Minister acknowledges that you have underfunded health,” Pearse Doherty claims. “So why did you throw in the towel?” he asked.

Doherty told the Dáil that the repercussions of the lack of funding in the budget will be seen “in the weeks and days to come”. 

If proven right, then this government will be facing tough questions, but in the next exchange, the opposition will not be so kind to come to the defence of the health minister. In fact, it will be quite the opposite.

With reporting by Muiris O’Cearbhaill