THE HEALTH Service Executive (HSE) has to devise a major costcutting plan which is likely to include bed closures, the lay-off of temporary staff and cuts in home help services in the face of a more than €1 billion shortfall in its finances this year.
The deficit could be more than €1.1 billion, the head of the HSE, Prof Brendan Drumm, has said.
Speaking yesterday following a special meeting of the HSE board held to discuss the deepening hole in the executive’s 2009 budget, Prof Drumm indicated that addressing the deficit may affect patient services.
“I think at this point in time it would be a very brave person that would say, in the face of a challenge of this size, that there won’t be an impact on services,” he said.
Already the HSE was implementing measures to make savings of €530 million this year. These measures included reducing overtime, converting seven-day hospital wards to five-day ones, converting inpatient to day-case surgery, and cutting travel and other expenses.
But now it says an extra €500 million in savings has to be made mainly due to the State’s worsening economic position. Some €400 million of this is accounted for by the reduced income from the health levy paid by workers and the extra medical cards which will have to be given to those who are unemployed. And at least some of the remainder will be needed to cover the cost of greater numbers of consultants than had been expected opting to take up new higher-paying contracts. About 85 per cent of consultants have switched over, it said.
The Minister for Health, Mary Harney, has just given approval for the higher salaries to be paid to consultants who switched over after the HSE verified they had changed their work practices. The higher salaries, in some cases amounting to €240,000 a year, will be backdated to the beginning of January.
In terms of other savings to be made by the HSE this year, it said an additional €205 million will be required as a result of a court order to repay pharmacists money deducted from them last year without agreement and because it expects savings realised as a result of the controversial decision to end the automatic right of people over 70 years to medical cards will not be as great as first expected.
The HSE’s financial crisis was outlined to members of the HSE board yesterday afternoon where it was decided the seriousness of the situation, along with draft proposals to address it, should be discussed with the Government before a final cost-cutting plan is considered at another board meeting in two weeks’ time.
Prof Drumm said it was very difficult to predict precisely what the HSE deficit will be. “Is it a €2 billion challenge? I don’t think it is. But is it a €1.2 billion challenge as against a €1.3 or €1.4 billion challenge, then that becomes a very difficult prediction,” he said.
Making the savings would be “extremely difficult”, he said. Asked if staff wages would have to be cut, he said people who work for the health service should not have to “become charities overnight” to fund patient services.
Hospitals had already been told their budgets would be cut significantly this year. In Dublin there was €7 million less for Tallaght, €6.8 million less for Beaumont, €6.5 million less for St James’s, €4.8 million less for St Vincent’s and €4.3 million less for the Mater hospital.
In the northeast, Cavan/Monaghan hospitals were told their budgets were being cut by €12 million and Louth/Meath hospitals were told to expect a €1 million cut. In the midwest, hospital budgets were to be cut by more than €13 million and in the west and northwest hospital budgets were already down by more than €29 million.
Labour and Fine Gael said frontline services should be protected.