HSE plans tougher savings measures

THE SERVICE plan drawn up by the Health Service Executive (HSE) for 2009 is being withdrawn and rewritten as a result of the …

THE SERVICE plan drawn up by the Health Service Executive (HSE) for 2009 is being withdrawn and rewritten as a result of the major financial crisis the executive is now facing.

The plan, published in December, outlined the programme of work the HSE expected to be able to fund this year from its €14.7 billion budget and gave details of the numbers of patients it expected to treat, the number of home care packages it expected to be able to deliver and so on.

However, late last week it emerged that due to the economic downturn and other factors the HSE is now facing a deficit of at least €1.2 billion this year unless corrective action is immediately taken.

The board of Tallaght hospital was informed on Thursday night that the HSE’s 2009 service plan was as a result being withdrawn and rewritten to factor in the fact that the executive now has more than €1 billion less to spend than when the plan was drawn up.

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The HSE wasn’t commenting on this yesterday. However, one HSE source suggested the plan was just being amended.

There is now speculation that the revised service plan may not just include ward closures, but the actual closure of some smaller hospitals, in order to make up the required savings, but whether or not this would be approved by Government is unclear.

Last week a HSE spokesman, when asked if the HSE would consider closing hospitals, said many courses of action would have to be considered before any such move would be looked at.

Meanwhile, the HSE told health service trade unions yesterday it is facing “stark choices” in how to deal with its financial deficit this year.

It is understood the HSE said it could protect jobs and services and secure the necessary savings by cutting non-core pay such as allowances and premium rates for its 110,000 staff. This, however, would be likely to cause outrage among staff who are already protesting at having their pay cut as part of the Government’s pension levy.

Alternatively, the HSE said it could cut back on services which would involve job losses for temporary staff while maintaining existing payment arrangements for permanent personnel.

The executive advised the unions that it is currently preparing a revamped services plan which will go to the board of the HSE in a fortnight.

The HSE is expected to meet union leaders again in advance of the meeting of the HSE board on March 12th.

The board of Tallaght hospital meanwhile was also told on Thursday night that the hospital is to get €12 million less from the HSE to run services this year. Figures released by the HSE earlier this week suggested the shortfall would be significantly less, at €7 million.

The situation at the other four main Dublin hospitals is similar with Beaumont set to receive about €11 million less this year than last. Again the HSE had said it would receive €6.8 million less.

And at St James’s Hospital the budget notified to the hospital is about €12 million less than last year when the HSE figures suggested it was only down €6.5 million.

The difference in the two sets of figures is accounted for by the fact that the HSE expects the five hospitals to collect an extra €19 million between them this year in private bed charges from health insurance companies as a result of the increase in the cost of private beds in public hospitals announced on Budget day.

However, hospital sources say this will be very difficult to achieve because many private rooms are used to isolate patients who have infections and to give patients, whether public or private, privacy in their final days. As a result hospital cannot bill private insurance companies for all the days that private beds are actually used.