A CONFIDENTIAL consultancy report on cost-saving proposals for health service management in the west has recommended that up to 1,000 staff on temporary contracts could be let go over the coming months.
The report by consultants Mott and MacDonald says such a reduction in staff on temporary contracts in HSE West or in voluntary organisations could generate savings of €15-20 million over six months.
However it warns that the majority of such personnel work in frontline services and cutbacks on the scale proposed are “likely to result in the downsizing and/or curtailment of some services”.
The report, which has been seen by The Irish Times, also recommends consideration of other cost-saving options including curtailing hospital services such as scaling back elective admissions for a defined period.
It also proposes a needs review of home helps and homecare services and the introduction of waiting lists for aids and appliances.
The report also states that savings could be realised by means of cuts in overtime, improved income generation and more efficient procurement practices.
The HSE last night said the report was a guide for management and no firm decisions had been taken. However it maintained that nothing was “on or off the table”.
HSE West, which runs from Limerick to Donegal, faces a financial deficit of about €80 million and has warned unions that significant cutbacks could be on the way.
The trade union Siptu is already balloting members in HSE West on possible industrial action. It has said that letting go temporary staff would be in breach of the Croke Park agreement.
The Labour Relations Commission, which was asked to intervene by Siptu and Impact, is scheduled to begin a hearing today.
The report, which was given to senior management in late June as a menu of options, sets out possible savings of between €44 million and €54 million.
It warns that in the absence of any workforce transformation, including redundancies, radical solutions need to be identified and supported.
The report says that management could consider providing daycare services on four rather five days a week, amalgamating beds across areas such as female surgery and gynaecology.
It estimates that savings of between €5 and €7 million could be achieved in a review of home helps and homecare services.
It proposes that a freeze could be introduced on new consultant appointments until next year.
In addition, it suggests that there could be a further reduction in grants to voluntary organisations.
However the report states that even these actions may not be sufficient to close the financial deficit gap and possibly other measures requiring a longer lead time might have to be “escalated”.
It says €4 million could be saved by cutting overtime by four to seven hours for non-consultant hospital doctors for six months.
The report also states that closing community nursing unit and acute mental health beds could realise €1 million, developing a region-wide drugs formulary could produce savings of €800,000. It says that implementing acute hospital and other service reconfigurations could release significant savings that have not yet been quantified.
In the medium term, “this could include the closure of a hospital and the transfer of beds to another site with the redeployment of permanent staff from and the cessation of temporary staff contracts at each of the sites”.
Last night the HSE’s national director of communications Paul Connors said HSE West was facing considerable financial challenges.
“In order to best protect services towards year end, it is obliged to take robust remedial cost-saving measures now. The Mott- MacDonald report is a tool that can assist management in achieving those savings.
“However it must be stressed that this is merely a guidance to management . . .
“While no firm decisions have been taken as of yet, nothing is on or off the table,” he said.