St James’s Hospital warns it faces deficit of €15m

Some hospitals preparing to operate on overdraft to minimise impact on patients


The country's biggest hospital, St James's Hospital in Dublin, has warned the Health Service Executive that its budgetary position is unsustainable.

The hospital wants the HSE to “rectify” its allocation to avoid recording a deficit of €15 million by the end of the year.

"We have repeatedly asked the HSE to take account of the hospital's increased complexity and volume of services, and its leading role in cancer services and many national specialities when setting its allocation provisions," a spokesman told The Irish Times last night.

“St James’s Hospital will continue to work with the HSE to ensure core patient services are protected in the short and long term, and we have urged the HSE that a rectification of the allocation be fully pursued immediately.”

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Earlier this week it emerged that the country’s hospitals were collectively €75 million in the red at the end of August.

Increased patient numbers, driven by a rise in respiratory problems affecting older people during the winter and a long, cold spring, have increased pressure on spending in hospitals across the State.

St James’s recorded the highest individual hospital deficit in August at €10.4 million.

A number of hospitals are making preparations to operate on an overdraft in order to minimise the impact on patient services over the coming months.

The HSE’s overall deficit by the end of the year is expected to reach €150-€200 million, and could be higher.

It was announced in the budget last week that €666 million is to be cut from the health budget next year, but since then it has emerged that the cut could be much larger, possibly up to €1 billion.

St James’s suffered the largest individual budget cut of any hospital when a rebalancing was carried out at the start of this year and its funding was reduced by €7 million.

The hospital says it has seen its funding cut by more than €100 million since 2009, with a €25 million reduction to the core patient services budget this year.

Included in this amount is €4 million deducted in respect of measures to increase income from private beds in the hospital this year, which are not now being implemented until next year.

Staff numbers
Another €1.5 million was deducted in anticipation of reduced staff numbers which have not materialised; the hospital says the framework for reducing numbers has not yet been established by the HSE and is unlikely to happen before year-end.

St James’s says the cut in its budget to reflect the Haddington Road Agreement is more than twice as high as the maximum savings it can fully verify.

It says €5.7 million in savings will accrue from the agreement but the corresponding budget cut is €11.2 million.

St Vincent’s Hospital in Dublin was €8.6 million over-budget in August, but HSE officials acknowledged it had opened 60 extra beds and was coping with complex demands in its emergency department due to the higher proportion of older people in its catchment area.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times