A “cost recovery” team has been established in Naas General Hospital to “rapidly” address its financial overspend, amid concerns the facility could exceed its budget by €41 million this year.The Health Service Executive is facing significant financial overruns, with chief executive Anne O’Connor last week stating its deficit reached €580 million by the end of July.In May, O’Connor placed three regions – Dublin and Southeast, Dublin Midlands, and the Southwest – in what is known as tier three escalation, which introduced employment controls and greater scrutiny on spending.A report from the HSE Cost and Productivity Oversight Group, dated August 7th and seen by The Irish Times, revealed a cost recovery team was established on June 10th to support Naas hospital in “rapidly addressing financial overspend”.The hospital in Kildare is a medium-sized acute public hospital with more than 200 beds and an emergency department.Spending from January to March 2026 suggested a deficit for the year of €41 million (31 per cent) against a budget of €132.5 million, the report said.The report noted that the financial challenges experienced by the hospital this year are “not new”.The hospital was given a “spend limit” of €155.8 million in 2025, versus an original budget of €131.8 million, “effectively an allowable overspend of €24 million that was not renewed in 2026”.According to the report, the hospital had a budget of €128.4 million in 2024, and this rose by €4.1 million to this year. However, it highlights that during that two-year period, pay rises increased by €5.4 million.[ Spending above €10,000 in health service now requires top-level approvalOpens in new window ]Agency spend is one of the main contributors to the deficit. The hospital spends €25.7 million on agency staff, up from the €11.3 million spend at December 2023.A total of €2.6 million is also being spent on “unfunded posts”, which the report attributes to the growth in medical staff since 2023. A further €2.1 million is also being spent on overtime. Regarding non-pay costs, the report pointed to the €2.6 million expenditure on local injuries units, the €2.2 million on drugs and medicines, the €1.4 million on labs and the €2.9 million on private hospitals.It outlined recommendations for the hospital to reduce spending, including speeding up the tender process for the local injuries unit, continuing the drive to eliminate or convert agency staff and tightening controls on non-pay spend.The report states a “similar process” is ongoing in Mullingar hospital, but it did not provide any detail about the extent of its deficit. A spokesman for the HSE Dublin Midlands region, under which the hospitals fall, said it is continuing to “assess the likely full-year financial outturn for its services including Naas and Mullingar Hospitals”.[ Surgeon at centre of concerns about children’s spinal surgery resignsOpens in new window ]The spokesman said the financial pressures being experienced reflect “increased service demand and activity, pay-related costs and non-pay costs”.He added that enhanced oversight arrangements were now in place, and these pressures were “being actively managed”.The national HSE office did not say whether further hospitals were facing similar difficulties. A spokeswoman said the cost recovery team had been “directed initially at the region that is under the most acute financial pressure”. “The team is planned as a multidisciplinary unit, operationally led and drawing on senior finance, HR, nursing and data expertise,” she said.Separately, there will be “additional controls” introduced by Government to ensure greater financial management of the health service, Minister for Public Expenditure Jack Chambers has said.He was responding to an Irish Fiscal Advisory Council report which found that the health overspend rose from €0.4 billion to €0.7 billion in August – on track to be the second largest health overspend in more than a decade.Chambers told RTÉ Radio’s This Week: “There has been ineffective implementation by the HSE of the controls that were agreed and were directed by Government in the last number of months and I’m very clear that there’s going to have to be further corrective action taken within the HSE about ensuring that there’s a strengthened control environment.”