Further cuts, in addition to the 250 bed closures announced by the five Dublin Academic Teaching Hospitals yesterday, are inevitable later in the year, the hospitals have said.
The Mater, Tallaght, St James's, St Vincent's and Beaumont hospitals say the cutbacks are being "forced" on them by funding shortfalls and will result in "at a minimum" 14,000 fewer patients being seen this year than in 2002. "Further reductions will be inevitable," their chief executives and medical board chairpersons said in a joint statement.
In addition to bed closures, there will be a reduction in overtime and the use of agency staff, vacant positions will not be filled and temporary staff contacts will not be renewed. "Cost reductions will also be sought in areas such as the purchase of drugs and in the maintenance and replacement of essential equipment," the statement said.
The loss of beds will increase overcrowding in hospital accident and emergency departments where waiting times for admission are already unacceptable. Elective admissions will also be cancelled, lengthening waiting lists. "This will inevitably mean potential delays in diagnosis of medical conditions, in the performance of necessary operations (such as cancer surgery and major cardiovascular treatments) and in the treatment of the sick with consequent unnecessary morbidity because they cannot get into hospital, including disability, deformity and pain (with reduced quality of life)," the hospitals' statement added.
The hospital group stressed that while there had been an increase of 8-10 per cent in funding for hospitals in this year's Estimates, their funding from the Eastern Regional Health Authority (ERHA) for 2003 was "practically unchanged" on the amount given them for the whole of 2002. They received €871.6 million last year and were allocated €871.4 million this year.
"In real terms this is a reduction as medical inflation is 10 per cent," they said.
The hospitals said they acknowledged the increase in health spending in recent years but it had to be seen against a backdrop of substantial increases in rates of pay, new technologies, new drugs, new service developments, greater numbers of elderly patients presenting and attempts to rectify serious deficits in infrastructure.
They emphasised that where funding had been provided for developments in cancer, cardiovascular and renal services, it would be protected and that the care of patients, once admitted, would not be compromised.
There are 2,800 beds in the five hospitals. Given that 250 will close and 350 are occupied by long-stay patients who have nowhere else to go, the equivalent of one major hospital will be unavailable to patients in the Dublin region this year.
Yesterday's bed closures are in addition to 115 announced by the Mater hospital last month. Earlier this month, Tralee General Hospital announced it would close 30 beds for the summer and Blanchardstown hospital has said it will begin the phased closure of 32 beds next week.
The ERHA's director of finance, Mr Liam Woods, said there had been a need "to pull back" on expenditure. He said the planned reduction in treatment of 14,000 patients should be seen in the context of the 222,000 patients treated at the hospitals last year. "It is a reduction back to planned levels of activity for 2002," he said.
The ERHA had received a 7-8 per cent increase in its allocation this year from the Department of Health. The teaching hospitals had received almost 50 per cent of the increase, some €67 million. The remainder had gone on childcare and other services.