\n<\/p>\n
Current funding model is \u2018not keeping pace\u2019 with the increasing demand and complexity of hospital services, Mater CEO tells Oireachtas committee<\/p>\n<\/p><\/div>\n
Funding proposed by the HSE to run the Mater Hospital this year falls \u20ac17 million below its overall spend in 2025, despite the facility forecasting a growth in the number of patients it sees in the coming months.<\/p>\n
The CEO of the Dublin-based voluntary hospital said that it has yet to sign a service level agreement with the HSE for 2026 funding, and told an Oireachtas committee that the current funding model is \u2018not keeping pace\u2019 with the increasing demand and complexity of its services.<\/p>\n
\u201cThe HSE Annual Service Arrangement process with its single year focus is in need of reform,\u201d said Josephine Ryan Leacy.<\/p>\n
\u201cNegotiations frequently begin from the previous year\u2019s baseline, despite clear growth in demand and activity.\u201d<\/p>\n
She told the Public Accounts Committee: \u201cThere is a strong case for moving to a multi-annual, activity-based funding model, linked not only to volume but also to patient complexity, acuity, age profile, and national referral responsibilities.<\/p>\n
\u201cThis would provide greater transparency, improved multi-year capacity planning, better value for money, and improved accountability.\u201d<\/p>\n
The Mater\u2019s chief financial officer Adam O\u2019Hare said that the HSE has proposed funding of \u20ac597 million for the Mater in 2026 \u2013 \u20ac17 million less than the hospital\u2019s 2025 costs.<\/p>\n
As a result, the Mater has yet to sign off on a formal agreement with the HSE on funding for this year. Similar disagreements over the level of funding the hospital required meant that 2025\u2019s service level agreement was only finalised in November of last year.<\/p>\n
Ms Ryan Leacy disclosed that, while the Mater broke even in 2025, it has an ongoing deficit of \u20ac48.7 million. Fianna F\u00e1il TD Albert Dolan pointed to a report from the hospital\u2019s auditors which warned that accumulated debts were so large that the hospital were \u2018at risk of trading recklessly under company law\u2019.<\/p>\n
\u201cWe cannot build on the \u00a348.7 million deficit that\u2019s there,\u201d responded Ms Ryan Leacy. \u201cWhat we wanted this year was a hope that we would start off with what we had forecast as a budget, that there would be discussions of how we would get as near to that, and then what we would have to do is map our service accordingly with that.\u201d<\/p>\n
Also addressing the Committee, CEO of Tallaght University Hospital Barbara Keogh Dunne said that her hospital projects a projected running cost of \u20ac471 million, fuelled by projected rises in demand for care as well as rising inflation and wages. The hospital also carries a historical deficit of \u20ac25 million.<\/p>\n
However, the HSE has proposed funding for the year of \u20ac438 million, which was the cost of services provided in 2025.<\/p>\n
She said that, in the first three months of this year, TUH saw a 12 per cent increase in ED attendances compared to the same period in 2025. Admissions from ED also rose six per cent.<\/p>\n
The meeting also heard from head of the National Treatment Purchase Fund (NTPF) Fiona Brady, who discussed plans to end by June the practice of third-party insourcing \u2013 the use of external companies to use spare capacity in public hospitals over and above core hospital activity, in order to get public patients treated faster.<\/p>\n
She said that other forms of insourcing involving existing staff being paid overtime, or the hospital hiring new staff funded by the NTPF, will remain in situ.<\/p>\n
Nine public hospitals have used NTPF funding for third-party insourcing, Ms Brady told the committee. Out of the \u20ac69.1 million spent on insourcing last year, \u20ac23 million went to external companies.<\/p>\n
\u201cWe\u2019ve reduced our insourcing funding significantly this year, in line with the public-only consulting contract,\u201d she said.<\/p>\n
\u201cWe\u2019re very aware that the hospitals are looking for more productivity from the consultants in that regard and we\u2019ve reduced our insourcing to \u20ac48 million this year. A third of that would be third-party insourcing \u2013 only till the end of June.\u201d<\/p>\n<\/p><\/div>\n
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