According to financial advisers everywhere, the best thing a person can do is to live within their means. But for the Irish national health service, this is proving difficult.<\/p>\n
A perennial thorn in the side of every individual at the helm of the Health Service Executive<\/a>, the discussion has changed in recent years.<\/p>\n The emphasis is no longer on the inevitability of overruns, and instead focus is on what steps can be taken to prevent overspending from happening again.<\/p>\n It was April when chief executive Anne O\u2019Connor<\/a> placed three regions, including the HSE South West region, under what is known as \u201ctier-three escalation\u201d.<\/p>\n This essentially involves the introduction of employment controls and greater scrutiny on spending.<\/p>\n At that point, the HSE recorded an overrun of \u20ac250 million in the first quarter. By the end of May this overrun had increased to \u20ac400 million. <\/p>\n The Minister for Health and senior health officials have consistently pointed to agency spend as one element driving expenditure that is over and above approved levels.<\/p>\n The desire to rein in spending is having real-world consequences for staff, management and patients around the country.<\/p>\n This was seen most acutely this week when the chief executive of Cork University Hospital<\/a> (CUH) warned the HSE that delays in approving posts and restrictions on recruitment were resulting in increased patient-safety risks.<\/p>\n \u201cI do not believe that the current position is sustainable, nor do I believe it is safe to enter the winter period with the level of staffing uncertainty that currently exists,\u201d Jennifer Kearney told the HSE in a letter.<\/p>\n [\u00a0Cork University Hospital short more than 1,000 staff, says chief executiveOpens in new window<\/a>\u00a0]<\/p>\n Public disclosure of such an argument is relatively uncommon, but rarer still is for unions to back hospital management.<\/p>\n The Irish Nurses and Midwives Organisation<\/a> described the recruitment approval process as \u201carchaic and bureaucratic\u201d, adding it was \u201cdamaging frontline services and staff morale, and impacting on patient care\u201d. <\/p>\n