HSE financial deficit could approach €1 billion, PAC hears

HSE Financial Deficit and 2025 Spending Growth

Total expenditure for the Health Service Executive reached €30.4 billion last year, marking a 7 percent increase from the €28.3 billion recorded in 2024, according to John Brady at the Public Accounts Committee hearing. Department of Health assistant secretary Louise McGirr told the committee that overall expenditure was running about 9 percent ahead of the previous year, outpacing the Government’s provided spending increase of roughly 5 percent.

While the HSE financial statements report a €1 billion deficit, chief executive Anne O’Connor clarified that this figure includes the 2024 deficit brought forward. Excluding that prior year, the underlying deficit incurred during 2025 sat at approximately €240 million, representing less than 1 percent of overall income, Ms O’Connor said.

Projected Overruns and Agency Staff Costs

Looking toward the end of the year, Dáil Public Accounts Committee members heard that the health service deficit could climb between €700 million and €800 million, though some TDs warned it could still approach €1 billion. HSE chief financial officer Michael Lane noted a recorded deficit of €660 million in the eight months leading up to the end of August.

“It is quite likely we are going to be in excess of €750 million. But my assessment is that it won’t be €1 billion,” Mr Lane told Fine Gael TD James Geoghegan, adding that cost reductions heavily depend on the delivery of planned non-pay savings around year-end.

Mr Lane also revealed that reliance on agency personnel—which runs about 30 percent more expensive than regularly employed staff—will cost roughly €800 million this year. The abolition of private practice in public hospitals is projected to cost the HSE about €140 million this year in lost hospital payments and altered doctor remuneration.

Consultant Remuneration and Unpaid Insurer Claims

Scrutiny at the committee also focused on top earner compensation and uncollected funds. Mr Brady told the committee that the top 10 earners in the HSE received a combined €6.8 million in 2025. The single highest earner pulled in nearly €910,000 in total remuneration, with more than €616,000 recorded as payments for additional work. HSE officials noted that this specific consultant is based at Cavan General Hospital, where four of the top 10 highest-paid personnel worked last year.

Ms O’Connor acknowledged it was “not good enough” that public hospitals lost out on approximately €7.5 million in income owed from private health insurers over a two-year period, largely driven by consultants failing to submit forms on time. The HSE subsequently informed committee chairman John Brady that roughly €125 million in claims from its own and voluntary sector hospitals had gone unpaid by insurers over a five-year period.

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