HSE has 'no contingency funds to cover strikes or bad weather'
The HSE has no contingency funding for strikes, patient surges or the impact of weather events, the new director general Paul Reid has been told.
The issue was raised by senior HSE manager Angela Fitzgerald, who highlighted the massive deficit in the HSE budget, as well as concerns over the safety of emergency care and the number of extra hospital beds being provided this year.
Details of further stark warnings by HSE management come as Health Minister Simon Harris told the Dáil that the latest figure for the HSE's budget shortfall stands at €116m.
Fianna Fáil said the lack of contingency funds is a "mistake".
Hospital services have been severely disrupted by two industrial disputes this year amid separate strike action by nurses and HSE support staff.
In her briefing for Mr Reid, Angela Fitzgerald - the HSE deputy director whose department oversees acute hospitals - warned of a projected deficit of up to €290m, while saying that measures are being taken to bring this figure down.
It stood at €103m at the time the briefing was compiled.
However, she also warned there is "no provision for contingencies such as industrial action, [patient] surge, [or] adverse weather events".
In terms of action being taken, she said financial plans are agreed with hospital groups with "interim pay controls in place".
The document also raises concern over access targets in emergency care, saying that the "current configuration of services is not optimal in terms of safe and effective service delivery".
It says that 220 hospital beds have been approved for 2019 - but 75 of these are only for four months and 1,200 are needed to meet a target of 85pc occupancy.
Elsewhere in the briefing documents, another manager said bed occupancy exceeds 95pc and demand for hospital admissions outweighs capacity in many locations.
Ms Fitzgerald also says "capacity deficits" in acute and community care "pose potential risks in terms of morbidity and outcome".
Among actions she lists that the health service is implementing are agreed bed capacity initiatives and leveraging Sláintecare funding, a reference to the cross-party strategy for reform of the health service.
In the Dáil, Mr Harris revealed the latest deficit figure of €116m but said he expects the HSE's financial performance will be better this year. A spokesperson for the HSE said that "as in previous years" its service plan "states clearly that the HSE is not in a position to hold a contingency against delivery or other financial risks".
"This is due to the cost of meeting increasing service demands."