Mr. Paul Reid:

I welcome again the members. I thank the Chairperson and members for the invitation. The Chairperson has introduced my colleagues so I will not do that again. He has also referenced a number of papers that we have submitted in advance so I will confine my remarks to a few key areas.

First, there is the annual financial statements 2020 and the financial outturn. The Covid-19 pandemic placed significant pressure on funding and expenditure during 2020. The HSE's overall reported income for 2020 is just over €20.2 billion and includes a once-off net additional funding allocation of €2.3 billion, of which just over €2.1 billion was in respect of 2020 Covid-19 costs with the remaining €200 million allocated to winter plan funding. The HSE's annual financial statements for 2020 record a final audited revenue income and expenditure surplus of just over €200 million.

Next is the annual financial statements 2021 and financial outturn. The HSE's 2021 annual financial statements were prepared and submitted in line with the required timelines to the Comptroller and Auditor General for audit. I understand that the audit process is nearing finalisation and is expected to be complete around the end of May in time for inclusion in the published 2021 HSE annual report. Subject to the finalisation of the audit, it is expected that the 2021 annual financial statements will record a revenue income and expenditure deficit of about €195 million. The deficit is entirely due to an excess of Covid-19-related costs, including vaccination, and test and trace costs, over available Covid funding.

In arriving at the net deficit of €195 million, the excess of Covid costs over the Covid budget was substantially offset by a surplus on core spending, which was due to the regrettable suppression of some core activity and knock-on delays in progressing new developments largely driven by the pandemic and our need to respond effectively to it.

Over the two years of the pandemic, from 2020 through to 2021, the HSE will have recorded a combined revenue surplus of €5 million or a combined surplus of €65 million over the three years of 2019 to 2022.

The national service plan for 2022 outlines the health and social care services that will be provided to the people of Ireland in 2022 within the allocated budget of €20.7 billion, which included the following. Additional investment in new measures, including the winter plan, of €310 million. Additional existing level of service funding €727 million, including: €286 million pay cost pressures which includes funding increments of €39 million; just over €364.4 million existing level of service and demographic pressures; and €77 million in terms of 2022 full-year costs related to Table 4 of the national service plan 2021. Additional once-off investment for Covid-19 costs of €697 million, including: €497 million for Covid-19 responses, including but not limited to, vaccination, and testing and tracing, personal protective equipment, PPE, and hospital and community Covid-19 responses; and €200 million to cover acute and community scheduled care access, including the use of public and private hospitals.

The national service plan focuses on the delivery, improvement and reform of healthcare services while continuing to manage a Covid-19 environment and is prepared within the strategic context of Sláintecare, the HSE corporate plan and the Minister for Health's annual statement of priorities and the winter plan.

I shall outline the financial position as of the end of March 2022, the draft revenue income and expenditure financial position at the end of March shows a year-to-date deficit of just over €250 million or less than 4.96%, with a significant element of this being driven by the direct impact of Covid-19, as reflected in the €224 million adverse variance in Covid-19 reported costs and €26.8 million or 0.6% adverse variance on core-related costs. However, from an overall perspective, it is expected over the coming weeks and months that our core, which is non COVID-19 activities, will naturally increase and the impact of delayed care will also increase demand for core services.

Finally, I will mention recruitment. The HSE has seen unparalleled growth in both 2020 and 2021 of an increase of 12,506 whole-time equivalents. This is in addition to recruitment via third party for staff in our Covid testing, tracing and vaccination services.  In 2022, the resourcing strategy approach is underpinned by a resourcing delivery range. The minimum point of the range sets out the minimum resourcing target at a net increase of over 5,500 whole-time equivalents, upon which the HSE will be monitored against, in addition to a higher target to allow for our commitment to maximising our recruitment and retention efforts. This level of recruitment is a net increase when recruitment to vacancies that arise are backfilled. This requirement, on an annual basis, is just over 9,500 posts.

In the past two years, the HSE has increased its recruitment capacity and capability through investment in national and local recruitment services. This has secured further resources and skills thereby removing potential barriers to domestic recruitment capacity and capability.

In recognition of the increased global competition for health and social care professionals, together with the ambitious recruitment targets, the HSE is supplementing its already robust recruitment strategies to maximise the national market with comprehensive international recruitment across clinical grades. I thank the Chairperson and members.