Poor Forecasting and No Plan on Agency Staff Glaringly Obvious in Dept of Health Supplementary Budget

• Poor forecasting and budgeting record of Department across elder care in the community, nursing homes and primary care.

• Home care support budget was one million home care support hours off budget.

• Department has no real plan to reduce agency spending despite cost of €750m this year.

• Budget 2026 is far off to meet existing level of service or new demand next year.

 

Labour’s Health Spokesperson Marie Sherlock TD was speaking after the 2025 supplementary health budget of €302.1m was discussed at the Health Committee today.

Deputy Sherlock said:

“It is clear from the supplementary estimates that we have a dysfunctional system for budgeting and forecasting in the Department of Health. Across the Primary Care Reimbursement Service (PCRS), eldercare, nursing homes and primary care, there has been an inability of the Department to realistically forecast demand.

“Bizarrely, the Department even failed to reliably forecast the spend on free HRT even though it was introduced six months after its original date of introduction. The failure to deliver this promise in January 2025 should have resulted in cost savings, not deficits.

“Even more worryingly, we know that there is a huge level of unmet need for home care support hours. Yet, the Department underbudgeted for the hours provided this year by one million home support hours. Similarly, in nursing home care, the Department failed to adequately budget and is now having to pump an additional €23.5m into homecare, and most seriously, in PCRS where the Department underestimated the 2025 spent by €143m.

“It is simply not credible that the Department did not expect higher drug costs or that people are living longer with chronic conditions requiring medication. Furthermore, parliamentary questions to my office hvae shown that 400,000 people are not claiming medical or GP visit cards they are entitled to. PCRS spending would be off the charts if they claimed those cards. The HSE must plan for people to claim the care they are entitled to rather than fluffing up their own numbers.

“Time and again, in the supplementary estimates, we are seeing savings made with pay being used to cross subsidise the increase in non-pay costs. This is most clear in primary care, where there was an underspend of €15m in pay. These savings are scandalous when there is huge recruitment needed right across primary care. To take one example, public dentistry is on the verge of collapse in many areas with staffing down by a third from 2009 levels. At the heart of Sláintecare is the concept that the greatest value for money occurs by keeping care in the community. The underspend in primary care is the very antithesis of that.

“Agency spend is set to top €750m and we heard from the Minister today that there is no real plan to reduce the grossly expensive overreliance other than to ask questions. We need the Minister to set out a clear plan, as the Government’s commitments made in March 2025 at the Workplace Relations Commission (WRC) appear to be dismally failing. Wringing their hands and saying staff cannot be tempted to take up direct employment is simply not good enough.

“The HSE are getting it terribly wrong on to forecasting and budgeting, which consistently requires supplementary budgets year-on-year. The Minister and the HSE must act to end the farce of drastic year-on-year supplementary budgets and ensure that services are adequately budgeted for, and that demand is accurately forecasted.”