Oireachtas Joint and Select Committees
Thursday, 5 October 2023
Public Accounts Committee
Health Service Executive: Financial Statements 2023
9:30 am
Mr. Bernard Gloster:
That concern is legitimate and shared. I will make three or four brief headline points. I know the Deputy has just joined the session. Earlier, I broke down the deficit into three categories. Non-pay inflation and increased demand driving non-pay account for about half of the problem. A quarter of the problem is increased demand. A quarter of the problem is for us to manage our budgets and processes in an improved way. I take responsibility for that part.
The €1.5 billion we are indicating as this year's problem did not all happen this year. There has been a succession of once-off supplementaries that are not repeated the following year. In simple terms, if there is a deficit this year of €1.5 billion on our balance sheet and the existing level of service, plus the incremental cost, is not funded going into next year, there will be a deficit at the same time next year. Even when I introduce efficiencies and controls, it will only deal with a portion of the issue. I do not know what level of funding we are going to get.
We all need, want and like new developments, initiatives and services. When they come into the budget profile, they come in at part-year funding. In the following year, if they are not fully funded, they add to the deficit. There is an incremental piece to this. That is just the way annual budget cycling has worked.
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