The health service was over-budget to the tune of €580 million at the end of July, despite measures taken by management four months ago to rein in spending.
The HSE paused recruitment in non-frontline roles across significant parts of the country in May, after the head of the organisation said its financial position had “significantly worsened”.
The health service overspent by €250 million in the first quarter of the year, with this rising to €400 million by the end of May.
Three HSE regions – Dublin and Southeast, Dublin Midlands, and the Southwest – were placed in what is known as tier three escalation, which introduced employment controls and greater scrutiny on spending.
Under this escalation, a pause on recruitment was introduced across all non-frontline, non-critical posts. Exceptions to these restrictions requires a business case to be approved by the regional executive officer (REO).
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HSE chief executive Anne O’Connor, said as of the end of July, the executive was 4 per cent over-budget, with this figure reaching €580 million.
“There’s a lot of work going on in terms of managing that. You’ll be aware that we’ve been at this now for a number of months – in terms of trying to bring controls in and look at how we can actually reduce costs across the health system,” she said.
Asked whether further measures would be required to curb the spending, O’Connor said “possibly”.
“All of our teams around the country are very focused on this. We have to work differently. We have to look at how we can provide more services to more people using the resources that we have, and that has to be the focus,” she added.
O’Connor was speaking to reporters at the HSE Integrated Healthcare Conference 2026 in Dublin on Thursday.
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Speaking at the conference, Minister for Health Jennifer Carroll MacNeill said an increase in productivity is needed to tackle budget overruns, and that significant investment and resources are already available.
In recent weeks, chief executive of Cork University Hospital Jennifer Kearney wrote to the HSE expressing concerns about staffing levels and patient safety risks.
However, the Minister said the region had hired 760 people in the first half of the year.
“Other regions have not hired in the same way. In many cases, it’s half of that. It’s really important that everybody understands that you can’t take from other parts of the country,” she said.
“Other regions are staying within the budget that they’ve been given, the budget that the people of Ireland have given them to manage the system. And all of those budgets have been uplifted.”
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Carroll MacNeill added that health service resources are not just for acute services, but are also needed for the community.
Ciaran Devane, chairman of the HSE board, reiterated the importance of community care.
“A figure that underpins that for me is that we have 545 avoidable admissions per 100,000 people, against an OECD average of 473. That’s quite a disparity,” he said.
“An avoidable admission is somebody who we didn’t support well in the community who ended up creating demand on our acute services. We would rather not be dealing with a price of failure – they’d rather be helping the next person to have great outcomes.”