Health crisis: cuts would lead to ‘draconian’ measures

Almost 300 hospital beds will be closed and 2,400 fewer high-tech operations carried out next year if the Government insists on making further spending cuts of several hundred million euro, the Department of Health has warned.

Opening hours will be curtailed in five emergency departments and a raft of new charges introduced if even deeper cuts being considered are implemented, it warns.

In its confidential submission on the Government’s comprehensive review of expenditure, the department says the “draconian” measures required to deliver the level of spending cuts suggested are not achievable and would “seriously compromise patient safety”.

The department says rather than reducing spending further the health budget needs an increase of €500 million next year to address the underlying funding deficit in its base. It says a further additional €200 million would be required over each of the next three years to meet the demands of an ageing population.

The submission comes as Minister for Health Leo Varadkar intensifies his demands for a €500 million supplementary budget estimate this year.

He is said to have told a private meeting at the Fine Gael "think-in" in Co Cork yesterday that the true level of his department's budget adjustment in 2014 is €900 million, comprising a "demand-led" spending overrun of €500 million and €400 million in separate cutbacks.

Free medical card

He also warned that the free medical card scheme for children under six could present political problems for Fine Gael following the review of discretionary medical cards. As part of the expenditure review, the

Department of Public Expenditure and Reform

has asked all departments to submit a range of options to ensure spending comes in under a defined ceiling. The Department of Health filed its submission after Mr Varadkar became Minister in July.

The submission says in order to comply with these instructions it would need to reduce health spending in 2015 by €213 million.

Additional savings

The instruction to identify additional savings options of 5 per cent on existing expenditure ceilings over the coming years would equate to €620 million in further cuts.

A €213 million funding reduction next year would involve reducing spending by €74 million in acute hospitals, €56 million on primary care and €24 million on disability.

To meet this target, the department proposes a “targeted reduction in high-cost procedures”, especially in orthopaedics (saving €24 million), closing 290 in-patient beds in hospitals with high agency nurse spending (saving €27.8 million) and reducing consultant and junior doctor usage (saving €25 million).

Twenty beds would be cut in St Vincent's, Tallaght, Beaumont, the Mater, St James's and Connolly hospitals in Dublin as well as at Cork University Hospital, Mullingar, Tullamore, Portlaoise, Drogheda and Naas. Ten beds would go in Cavan, Waterford, Navan, Louth and Limerick.

The proposed reduction in high-cost procedures would include 416 fewer hip replacements, 153 fewer knee replacements, 121 fewer coronary interventions and 104 fewer cranial procedures.

To achieve the larger target of reducing health spending by €620 million, a long list of other possible cuts are set out. These include the closure of 24-hour service at five emergency departments – Portiuncula (Ballinasloe), South Tipperary (Clonmel), Naas, Portlaoise and Mercy (Cork).