One of the biggest children's hospitals in the State, Our Lady's Hospital for Sick Children in Crumlin, Dublin, is considering an extensive range of cost-cutting measures, including ward closures and staff reduction.
The Irish Times has learned that the hospital has drawn up a list of 26 proposals it will consider in an attempt to live within its budget this year which, in real terms, is over €5 million less than last year. The list proposes:
Reducing activity to 2001 levels;
Ward closures at weekends by focusing on day surgery on Fridays and not admitting elective patients on Sundays;
Reducing staff numbers through early retirement, career breaks, job-sharing and redeployment;
Encouraging unpaid leave during summer/Christmas;
No admission of patients over the age of 16;
No admission of children from outside the Eastern Regional Health Authority (ERHA) area for ear, nose and throat procedures such as tonsil removal and insertion of grommets;
Billing other hospitals or health boards for treating patients from their areas;
No elective surgery after 5.30 p.m. to cut down on overtime.
Tighter controls on ordering of couriers and taxis are also proposed while employment agency fees are to be re-examined and there may be less contract cleaning.
Our Lady's, currently the subject of a weekly TV series, is facing a very difficult financial situation, its chief executive, Mr Paul Kavanagh, admitted last night.
He said the hospital's budget was €78.4 million this year compared to €76.5 million for 2002.
However, in real terms it was more than €5 million less than in 2002 given that the hospital carried a €2.4 million deficit into 2003 and had to bear the costs of pay increases amounting to €1.8 million. "So this year I've €71 million in round terms as opposed to €76 million last year," he said.
Yet, he said the Eastern Regional Health Authority expected it to maintain services at 2002 levels.
He said the list of cost-cutting measures drawn up were "a preliminary exercise". He emphasised every attempt would be made to protect essential services and the specialist services provided by the hospital which were not available elsewhere.
He said in many instances children were travelling to the hospital from counties outside the Eastern Regional Health Authority area such as Wexford, Carlow and Kilkenny for procedures they could have in their own areas. This would have to be stopped.
Mr Kavanagh said even with all these measures, one would be optimistic to suggest the hospital could make up its €5 million shortfall. In this regard the hospital was open to having its budget independently examined, he said.
Crumlin is the latest in a series of hospitals to consider cuts.
The Mater Hospital announced last week that it would have to close 115 beds; Beaumont Hospital has considered limiting cancer treatment and kidney dialysis services.
In Galway, consultants at University College Hospital have been told to carry out 7,500 fewer treatments in 2003.