The HSE has admitted that only two-thirds of the projected pay savings under the Haddington Road agreement will be made this year, thereby making it more difficult for the health executive to balance its budget and increasing the likelihood of it needing yet another year-end 'bail-out'.

The health executive's latest financial report, for the end of July, says it is anticipated that approximately one-third of the Haddington Road targeted savings of €150 million will not be achieved in 2013, primarily due to time delays in implementing the agreement.

The report warns that the HSE is facing a deficit on its direct services of around €107 million by the end of the year, including a €75 million deficit on hospital schemes.

Hospital and community service providers have been asked to identify additional cost containment measures to safely bridge the direct services deficit, the HSE report says.

The HSE says the direct services deficit may also be offset by the use of 'once-off surpluses', and therefore it expects to break even under this heading at the end of the year.

However, the direct services deficit does not include projected deficits on key areas such as Haddington Road, the medical card scheme and private patient income in public hospitals. The HSE has pointed out that it does not have the capacity in its budget to meet these shortfalls.

The total HSE deficit at the end of the year therefore could well be well over the €200 million mark as a result of this, indicating that the health executive may need yet another 'bail-out' from the Department of Health.

The report shows that the HSE's is projecting a deficit in its PCRS scheme, which includes the medical card scheme, of between €65 million and €100 million.

In addition, the postponement of legislation aimed at charging private patients for occupying public hospital beds until next year means that hospital deficits will as a result of this increase by €10 million a month in the last six months of this year.

The HSE is also behind in its target for accelerating the collection of private patient income it is already owed for hospital accommodation.