The HSE has yet to decide where €108 million in health cuts, out of a total package of €619 million in spending reductions from next year, will come from.
Tony O’Brien, the director general of the HSE, said on the publication of the new HSE service plan today further work has to be carried out within the departments of the Taoiseach, Health and Public Expenditure and Reform.
“We can’t say where it’s going, we know where it’s coming from,” Mr O’Brien said, adding the “deliverability” of the target will have to be examined.
The service plan for 2014 also says some savings will be made from hospital reconfiguration, which could mean downgrading some accident and emergency services. It also confirms the money to be saved from medical card probity tests has dropped from €113 million to €23 million.
“The HSE, working closely with the Minister for Health and his department, succeeded in ensuring that the target of €113 million set against medical card probity will now come from other sources rather than from medical cards,” a HSE statement said.
Mr O’Brien said the original target was “was not achievable and the consequences of achieving it were not desirable”.
The number of medical cards will be reduced by 15,000 next year. The total €619 million in cuts is broken down under a number of headings, with “pay and flexibility” accounting for €268 million in reductions.
This is further broken down into €140 million in savings under the Haddington Road Agreement, the €108 million is “unspecified savings”, which will be detailed in a further process to be carried out, and €20 million from employment control.
However, the HSE did not provide more details on where the €108 million could come from.
“The savings target of €108m, which was the element of the overall targeted payroll savings, will now be put to one side and subject to a separate process over the coming months,” a statement said.
Other areas which will provide savings include procurement, shared services, value for money initiatives and hospital reconfiguration.
The HSE is also budgeting for a reduction in inpatient and day case discharges, elective inpatient admissions and outpatient attendances.
Another €150 million in savings pencilled in for 2013 must also be made in 2014. However, €304 million will invested areas like mental health, free GP care for children under six, as well as meeting demographic needs.