The Department of Public Expenditure and Reform (DPER) and the HSE have expressed concern that some spending during the Covid-19 pandemic “could become embedded”.

According to minutes of the health budget oversight group meeting in September, DPER officials “raised concerns in relation to Covid-19 funding that was provided on a one-off basis becoming embedded into core healthcare expenditure”. The minutes stated that the HSE “shared this concern and highlighted the risk that some costs could become embedded”.

A DPER spokesperson stated that “in relation to temporary expenditure supports, the careful phased withdrawal of Covid-19 supports is essential both to support society and… to return our public finances to a sustainable position”. The spokesperson noted that since 2020, approximately €5 billion had been allocated towards Covid-19 in the health sector. While the trajectory of the virus was “still uncertain”, expenditure across public health Initiatives “can be expected to reduce in line with the epidemiological situation”.

“Other extraordinary [Covid- 19] interventions will continue to be assessed with regards their ongoing suitability, particularly in the context of other Sláintecare priorities,” they added. A HSE spokesperson said despite the vaccination programme, “there continues to be a high level of embedded Covid-19 expenditure across the health system”. The spokesperson said there needed to be a “clinically-guided and operational-led approach” to determine which individual responses should be “maintained or ramped down”.

Examples provided by the HSE of one-off Covid-19 funding that may risk becoming “embedded” included: Extended working days to achieve physical distancing; new spaces to allow for distancing; required additional staffing; agency and overtime for support staff; rent and rates for additional accommodation spaces; extended security services; ventilation and maintenance costs; additional cleaning costs; and waste disposal for personal protective equipment and consumables. Meanwhile, the HSE revealed that a “structured after-action review” of the health services’ response to the pandemic “would be premature at this point”.

The spokesperson said that a “critical after-action review” would be “important”. However, considering the continued impact of Covid-19 on services, such a “structured” review “would be premature at this point”. According to the Executive, it “continually reviews” all aspects of its services to respond and “adapt to changing pressures from day-to-day” and these ongoing reviews take place through the HSE “governance pathways”.

In response to queries, its spokesperson said “although wider society has moved towards normalisation, the HSE is still under intense pressure managing day-to-day Covid-19-related pressures, as well as other demands”. “With this in mind, the HSE has not at this point planned an afteraction review of its response to the pandemic. The value of this, however, is well understood.”