Funding is provided to the HSE for health services in accordance with the Letter of Determination which sets out the approved level of overall HSE expenditure for the year in question. It is the responsibility of the HSE to manage the entire budget and prepare and implement the National Service Plan which must, under legislation, set out the type and volume of health and personal social services, to be provided during the year in question within the funding allocated.
It is for the HSE to determine what healthcare services, products, and interventions would best maximise health gain for patients and the public within the resources available to them, including savings that would accrue from implementing new initiatives.