Cuts and closures all round as HSE runs €133m over budget


THE HEALTH Service Executive’s four regions were €133 million over budget at the end of May, with the west region – which runs from Donegal to Limerick – accounting for the biggest percentage overrun.

However, there were significant deficits building up in other parts of the country too, as shown in the diagram on right. Given the €1 billion cut in health service funding this year, cuts in services and bed closures have been unavoidable.

In May, Beaumont confirmed it was closing 52 inpatient beds and would also have rolling theatre closures for the remainder of the year. The HSE said it planned further bed closures as more long-term care patients were discharged.

In June, Dublin’s Mater hospital confirmed 60 beds were being closed and a further 20 may be closed later in the year.

At the beginning of the year the HSE’s outgoing chief executive Prof Brendan Drumm said 1,100 hospital beds would have to be closed this year, but claimed this could be done without any major impact, with more day cases and shorter stays in hospital.

Since last month, there have been cuts in elective surgery at hospitals across the country. The HSE said scaling back of such activity during the summer months was normal as staff take holidays, but Peter O’Rourke, an orthopaedic surgeon at Letterkenny General Hospital, where elective orthopaedic surgery has been cancelled for three weeks, said this was being done “purely and solely as a money-saving exercise”.

Last November and December when he spoke out about being left idle as a result of the cancellation of joint replacements at his hospital, he said Minister for Health Mary Harney suggested he run extra clinics or take holidays.

“I ran an extra clinic, put 30 people on the waiting list and was then told not to do any more extra clinics. I wasn’t allowed because for me to run an extra clinic it requires extra nursing time, so I was costing more money and it put more people on the waiting list, which I’m sure did not look good”.

In the south, the HSE said Cork University Hospital had initiated a programme of rolling theatre closures during the summer months to coincide with consultants’ annual leave.

At Waterford Regional Hospital, the HSE said three theatres, 15 day beds and 10 inpatient beds closed for July and August, but would reopen in September.

In the midlands, Mullingar hospital has reduced its elective service for the summer months.

In the northeast, the HSE said last month that all options were being considered in a bid to contain costs at Our Lady of Lourdes Hospital in Drogheda and Cavan General Hospital.

The largest children’s hospital in the State – Our Lady’s Hospital for Sick Children in Crumlin – which was at the centre of controversy last year over ward and theatre closures, said while 25 beds that were closed in 2009 remained closed, it had no plans to scale back services further this year. The situation is still under review.

Community services have also been affected by the funding cuts. Both Age Action Ireland and the Carers Association said they had had calls from members whose home help hours had been cut. Enda Egan of the Carers Association said cuts in home help services were “pretty widespread”.

“I had a case last week where a person was getting one hour a week and now it’s down to half an hour a week . . . you wouldn’t say hello to somebody in half an hour,” he remarked.

A woman in the southeast, who cares for two people, and who had her home help hours cut by more than half in recent weeks said she would prefer not to be identified for fear of being targeted again.

But she described the move as a false economy, saying if the cut resulted in her having to put her two charges into State care, the cost to taxpayers would be much higher.

Gerry Scully of Age Action said older people in public long-stay facilities, including mental health facilities, were also being told they had to apply for the Fair Deal scheme and go into a private nursing home. “That is very unfair. We are telling people to dig their heels in . . . we suspect it’s to save money and that is really the agenda here,” he said.

Services have also been cut due to short staffing as a result of the moratorium on recruitment in the public sector. It, too, was introduced to save money.

A survey of the impact of the moratorium on the provision of nursing services in the HSE West region found a complete lack of service in some public health nursing areas, reduced services to postnatal mothers and their babies who require developmental checks, while a number of vaccination targets were not met.

Meanwhile, a cap on funding for dental services for medical card patients has also caused huge unrest and is being challenged in court by a number of dentists who have claimed it will put them out of business. The cutbacks announced in April restrict treatment for medical card holders to emergency care. The joint Oireachtas health committee was told last month cuts were also affecting patients.

In the HSE West region there has been a range of proposals to cut costs put forward in recent weeks. Details of a report from UK consultants Mott MacDonald on possible cost-containment measures in the region suggest up to 1,000 temporary jobs could be axed and the “closure of a hospital” could even be on the cards.

The HSE has claimed the report, which set out possible savings of between €44 million and €54 million, was just a guide.

However, it maintained nothing was “on or off the table” as it faced a deficit of €90 million by the end of the year. It is expected to outline to unions in coming days exactly what cost-containment measures it plans to put in place to achieve this.