The Government allocates a budget to the department of health and the HSE every year so that they can provide health and social care to people in Ireland.
The HSE National Service Plan explains the services that are funded by the budget.
All revenue and capital expenditure across all HSE services are covered by this funding.
The budget is spread across our services, either using traditional block funding or using an Activity Based Funding approach.
The HSE Annual Report and Annual Financial Statements describe how services have been delivered each year. It includes a breakdown of how the budget is managed.
Budget allocation
Budget is allocated across the HSE as follows:
- Hospitals – 39%
- Primary Care, including the Primary Care Reimbursement Service (PCRS) – 23%
- Social Care – 18%
- Others – 15%
- Mental Health – 5%
Source: Department of Health. Health In Ireland: Key Trends 2022
Our Financial Responsibilities
The HSE must have consistent financial management systems in place.
This helps us to comply with the Health Act 2004 and the Code of Practice for the Governance of State Bodies.
National Financial Regulations
The National Financial Regulations (NFRs) help the HSE to make financial decisions and transactions. All staff across the HSE have a responsibility to be aware of the NFRs, how they apply to the day-to-day operations of their work.
The NRFs set out minimum requirements that must be followed in order to be compliant.
The minimum requirements include:
- Irish and EU statutory requirements
- Achievement of Best Value for Money
- Government policies and guidelines
Procuring goods and services
In buying goods and services, the HSE must comply with the NRFs and the EU Directive 2014 / 24 for public procurement.
The HSE is required to ensure that all contracts are secured in line with public procurement requirements. We also much report any non-compliance.
Governance of Grants to Outside Agencies
Some of our spending relates to grants that are paid to voluntary agencies that provide health and social services on behalf of or in partnership with the HSE.
Each year, we fund around 1830 agencies in Ireland. These include large hospitals, service-based charities and small community organisations.
Grants are governed under the Health Act 2004.
Before grants are given to any organisation, the HSE decides the level of service to be provided and the maximum amount of funding that can be granted.
Regular performance review meetings take place between the HSE and this organisations to ensure that accounts are being managed correctly.
The review also checks that activities and services are being carried out in line with our guidelines.
Tax Compliance
The HSE its own team of tax experts who work within the organisation. These professionals have a good connection with the tax authorities and can consult external advisors when needed.
The HSE is committed to compliance with all tax rules.
Finance Reform Programme
The team involved in the HSE Finance Reform Programme is working on a new system for the entire health sector called the Integrated Financial Management and Procurement System (IFMS).
This system will provide standardised financial and procurement information, and financial management and reporting guidelines. Its aim is to improve financial transparency and compliance in the health sector.
The Financial Management Framework supports the work of the IFMS. It defines the processes and governance required for effective financial management in healthcare.
IFMS started implementation in July 2023 and plans to have the full HSE statutory expenditure and the expenditure of three other organisations on IFMS by mid-2025. After this, all remaining voluntary health organisations will join the system.