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Internal Health Service Executive paper indicates shortfall of nearly €56m
Hospitals and doctors received money from payments made – predominantly by health insurers – in relation to private patients treated in public hospitals. Photograph: Getty ImagesThe elimination of private medical practice in the public system has contributed to hospitals facing a projected income shortfall of nearly of €145 million, the A confidential financial report for senior HSE management, dated August 28th, says income was down by €55.9 million to date, with hospitals “severely impacted by the move of consultants to public-only consultant contracts ”.
In a statement, the HSE later confirmed that the full income impact of the new POCC contracts indicate a 2026 shortfall in private patient income of approximately €145 million. Under this new arrangement, senior doctors in hospitals received higher salaries in return for the elimination of rights to treat fee-paying patients in public facilities.
Publican says he can’t pay cleaner after losing nearly €200,000 in four months running barBoth hospitals and doctors received money from payments made – predominantly by health insurers – in relation to private patients treated in public hospitals.will be phased out over time as consultants with contracts allowing them to see fee-paying patients retire. Private practice rights for doctors who signed up to the new public-only contract expired at the end of last year.
All newly appointed consultants work under the public-only contract. The internal HSE Cost and Productivity Oversight Group report specifically says “income remains significantly challenged due largely to impact of POCC roll out” in“Overspend is system-wide, with all six health regions reporting adverse variances. range from 3.3 per cent in the West/North West to 6.7 per cent in Dublin Midlands.
“Regions collectively account for €446.5 million of variance while corporate and national services contribute a further €131.4m . ” The report indicates that while spending on staff for the health service secured through agencies – which is more expensive than personnel appointed through regular recruitment – had reduced, it is still €56 million more than projected.
“Year to date agency expenditure €476 million versus ceiling of €419.6 million, an adverse variance of €56.4 million ,” notes the report. “Variance has improved compared to the June year-to-date position . Agency spend continues to reduce. July spend is €0.82 million below June spend versus 30 days in June”, the report says.
In a statement, the HSE said that the new POCC contracts “continues to be monitored” but that “current projections indicate a 2026 shortfall in private patient income of approximately €145 million".
“The HSE received €100 million in additional Exchequer funding in 2026 in recognition of the anticipated shortfall in private patient income," it added. At the weekend, Minister for Public Expenditure Jack Chambers said “additional controls” would be introduced by Government to ensure greater financial management of the health service.
He was responding to an Irish Fiscal Advisory Council report which found that the health deficit increased from €0.4 billion to €0.7 billion in August – leaving it on track to be the second largest health overspend in more than a decade. Chambers told RTÉ Radio’s This Week programme: “There has been ineffective implementation by the HSE of the controls that were agreed and were directed by Government in the last number of months and I’m very clear that there’s going to have to be further corrective action taken within the HSE about ensuring that there’s a strengthened control environment.
” In May, HSE chief executive Anne O’Connor placed three regions – Dublin and South-East, Dublin Midlands, and the South West – in what is known as tier-three escalation, which introduced employment controls and greater scrutiny on spending.
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