Senior health service managers will have to adopt higher levels of personal accountability for budgetary spending in return for the Government delivering major new investment, according to Minister for Finance Paschal Donohoe.
Asked about Taoiseach Leo Varadkar’s criticisms yesterday of health budgets, Mr Donohoe said establishing a strengthened Health Service Executive board – as well as new management leadership – were key changes that would have to accompany increased funding for the health sector.
Speaking at the National Economic Dialogue in Dublin, he said the introduction of a healthcare framework like SláinteCare would have to be accompanied by a higher level of personal accountability in relation to health expenditure.
Mr Donohoe acknowledged that there had been a massive amount of debate in the Oireachtas in recent years as to the appropriate governance model for the health service.
Earlier this week it emerged that the HSE had accrued a deficit of €101.5m during the first two months of 2018.
Yesterday Mr Varadkar said the health service posed the greatest reform challenge, adding that it was difficult to justify expenditure of €15bn this year in light of Ireland’s relatively young population.
Asked about his budgetary targets, Minister Donohoe reiterated that the Government was targeting a deficit of no more than 0.1% but said that if opportunities presented themselves during the year to go beyond that, it was something the Government could consider.
He said that a deficit of 0.1% – combined with the setting up of a rainy day fund – would mark the second year in a row that the books were broadly balanced and the national finances had improved over the previous year.
He stressed that the Government would be increasing capital expenditure by €1.5bn next year, and a major beneficiary of that funding would be Minister for Housing Owen Murphy to address the Ireland 2040 programme.
Mr Donohoe said he was committed to tax reform and indicated that one of his priorities would be to address the situation where someone on an average income could be paying the higher rate of tax.
He said last year’s budget showed that by broadening the tax base and making careful choices about current expenditure, the Government could continue to make a difference.