The Oireachtas Health Committee has heard that Ireland's ageing population, a rise in chronic diseases, increased spending on new and existing medicines and increased payouts from the State Claims Agency, have contributed to the Health Service Executive budget overrun this year.
HSE Chief Financial Officer Stephen Mulvany said that to the end of August, the executive had overspent its budget by €485 million.
Demand-led schemes and increased emergency department attendances are also adding to the overrun.
A supplementary estimate of €700m has been allocated by the Government for the expected end of year health overrun.
Colm Desmond of the Department of Health’s finance unit said that there was a degree of unpredictability in the service requirement for health.
Fianna Fáil TD Stephen Donnelly said he did not accept that demographics was contributing to the overrun, given that demographics are entirely predictable and can be budgeted for.
He said that up to 2013, the HSE annual overspend was about €100-200m.
Mr Donnelly said that since 2014, something had changed in the HSE, the Department of Health or Government, as the overruns had tripled and now are about €600-700m a year.
Mr Mulvany told the Committee that over €200m of the current HSE overrun related to unfunded cost growths, that are outside of the areas of spend, which are amenable to normal management control efforts, or relate to exceptional costs such as those associated with Storm Emma.
He said this included extra spending in the Primary Care Reimbursement Service of €50m, State Claims Agency €32m, Local Demand Led Schemes and Overseas Treatment €24m and Storm Emma €28m.
There was also €63m less in private health income for acute hospitals.
Mr Mulvany said there was a further €180m in savings not achieved.
Mr Donnelly asked about accountability and if anyone in the HSE had ever been fired, or sanctioned, for the annual Budget overruns.
He said that in recent years the overspend had been between €500-700m a year.
He said that if this was a private company, the chief executive would be fired.
Mr Mulvany said that no-one had been fired, or had faced a disciplinary sanction, however performance notices had been issued in some cases.