What will happen when the money runs out?

There is increasing disquiet among many health managers at what they say has been undue pressure on CEOs to sign service level agreements with the HSE within truncated timeframes. Maureen Browne reports.

Maureen Browne
Maureen Browne

Managers are very concerned as to what will happen when and if the money runs out this year – when a supplementary budget has been banned and they have signed agreements to provide levels of services which they believe they may not be able to resource as the year moves on.

These managers feel very vulnerable and fear they face being pilloried for being unable to provide services later in the year – the old problem of responsibility and accountability without authority.

There is also concern at the amount of staff time being taken up by constant HSE demands for very detailed information on compliance and other issues.

I am not confident that the money I have been allocated will enable me to provide the services which I anticipate will be required for the full year.

“The whole matter of being rushed into agreeing service levels with the threat of budget cuts if we didn’t sign on the dotted line in time has been particularly worrying this year, in view of the fact that we are told there can be no supplementary budget,” said one health manager.

A hospital colleague agreed saying he was very anxious about the situation of particular demand led acute services for which he is responsible. “I am not confident that the money I have been allocated will enable me to provide the services which I anticipate will be required for the full year.  There are areas where we can expect a surge in demand, especially with new treatments and technology and there is no clarity as to what will happen if the money runs out before the end of the year.   In emergency situations previously, there was always the prospect of a supplementary.”

One manager said he was very anxious about what would happen over pensions.  “Everybody over 50 has the right to go on a pension and at this stage of the year we have no idea who may or may not decide to go.  In the past there was always a supplementary budget for pensions, but there is no indication of how we are to fund them this year.  It is an expense which we just cannot predict at this stage and if a number of our staff decided to leave I don’t know where we will find the money for their pensions.”

“Some of us have been trying to give ourselves some protection with caveats and covering letters, but we do not really have any faith that these will work when the chips are down.”

Managers are also worried about the staff time taken up by the amount of increasingly detailed information being sought by the HSE.

The level of information being sought in very tight timeframes is also worrying managers.

“I am a great believer in compliance,” said one manager.  But I am finding it increasingly difficult to keep up with the level of detail now being demanded by the HSE…  We are getting what many of us consider overly detailed lists and more and more of our staff are being diverted away from their main jobs to provide this information to the HSE.  I believe if they want this information, they need to prioritise it and not be looking for everything within a couple of days.  If they want all this information instantly, they would need to provide us with more staff as we are being put in the position of having to take people away from their day jobs to answer these endless queries.

“I understand that every hospital is to be audited for compliance over a three year period, but it should be appreciated that as far as information is considered some of us are starting from quite a low base.”