Hospitals face nearly €250m in cuts under HSE plan

Comprehensive reviews of eligibility for medical cards planned for this year

HSE director general Tony O’Brien, who says he can not give details of the drugs  the health executive plans to “delist” from the medical card scheme. Photograph: Alan Betson / The Irish Times
HSE director general Tony O’Brien, who says he can not give details of the drugs the health executive plans to “delist” from the medical card scheme. Photograph: Alan Betson / The Irish Times

Acute public hospitals will have to make do with nearly €250 million less in funding from the State this year.

Separately there will also be “comprehensive reviews” to determine whether people with medical cards or GP visit cards are actually eligible to hold them. Some drug products will also be no longer available to patients under the medical card scheme as part of €142 million in new savings to be put in place in the HSE’s primary care reimbursement service.


Mental health services
Details of the cuts were set out in the HSE's divisional service plans – its plans for acute hospitals, primary care, mental health and other services – which were published yesterday.

HSE national director for acute hospitals Ian Carter said that on average acute hospitals would face reductions of about 4 per cent in their allocations this year.

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St James’s Hospital in Dublin, the country’s largest, faces a reduction of nearly €13 million this year in comparison with its final out-turn allocation for 2013.

Tallaght hospital and the Mater hospital face cuts of about €12 million compared with their out-turn figure for last year.

The plan also shows that the HSE is projecting there will be about 3,000 fewer in-patients treated in public hospitals this year compared to 2013.

The number of day-case procedures carried out is also expected to fall by about 24,000 under the HSE plan for the year.

The service plan for acute hospitals states: “Cost containment plans to the value of €56.5 million were put in place in 2013. Additional measures to these will be implemented during 2014.”

Under the plan hospitals have been set a target to generate savings of €60 million under the Haddington Road agreement on pay and productivity. A further €7.5 million in savings is earmarked from reconfiguring services.

The service plan for primary care services says “primary care schemes through the Primary Care Reimbursement Service include a cost reduction challenge of €231 million in 2014, as well as a carried forward cost reduction target of €353 million applied in 2013.

“While reference pricing and prescription charges will deliver reductions and increased income, the plan for 2014 will involve comprehensive reviews of client eligibility to ensure that only those entitled to medical and GP visit cards receive them and retain them,” the plan says.


'Delisting' drugs
The director general of the HSE, Tony O'Brien, said he could not give details of the drugs that it plans to "delist" from the medical card scheme.

“There is a specific process that has to be gone through by virtue of agreements that exist with the industry and if I were to do that here I could be in breach of those agreements and that would not be helpful.”

Fianna Fáil spokesman on health Billy Kelleher said the €200 million in funding cuts for hospitals would compromise patient care.

He said they were a testament to the inability of the Minister for Health James Reilly to secure the necessary resources.

“The fact is that the HSE is providing for the number of in-patient treatments and day-case treatments to be cut in 2014,” Mr Kelleher said.

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.