The health service cannot absorb a further €600 million in cuts without it affecting people at some level, the out-going chief executive of the Health Service Executive has said.
In an interview with RTE this afternoon Prof Brendan Drumm said that the organisation would have to try to minimise the effect of the cutbacks by continuing to change the way things were done.
He also signalled that the cutbacks could mean that in the future smaller hospitals serving catchment populations of 300,000 to 400,000 people, may not operate on a 24-hour basis.
The Minister for Health Mary Harney warned last week that the scale of cuts in the health budget next year would be "substantial" and would have a serious consequences for health services.
It has been widely reported over the last week or so that the Government will seek to reduce €14 billion health service budget by around €600 million or so next year.
Speaking on the "This Week" programme on RTE Radio, Prof Drumm, who steps down next month", said that it would be very difficult to make the level of cuts envisaged without impacting on services but that it was possible "if we are willing to make very significant changes".
Prof Drumm said , for example, in the West of Ireland where the HSE was facing significant financial pressure at the moment, there was "no justification " for having four hospitals open every night for 300,000 people across Galway and Roscommon.
He said that in three out of four of those hospitals there may only be one overnight surgery carried out per month and in some cases maybe only once per year.
"We pay massive costs up to €10,000 per night in overtime to keep them open and at the same time we are having to take out a home care package for an elderly person who needs care for a pneumonia at home for the next week", he said.
Prof Drum said that since 2007 the HSE has managed to reduce its expenditure spend by €1 billion – not counting the pay cuts introduced by the Government – and cuts it staffing levels of 6,000 because people were working differently.
He said that the reduction of the employment figures by 6000 had generated savings of about €300 million while there had also been around €350 million saved in drug costs and a further €250 million in back-office costs.
He said that procurement savings had also realised a further couple of hundred million euro.
Prof Drumm said that the HSE had "moved away from the way of thinking that said reducing the amount of money we get means that we straightaway reduce the services we provide".
He said that threatened cuts to respite services as a result of cutbacks in fundings to voluntary agencies would not now be introduced.
Prof Drumm said that respite services had been put back after the HSE had sat down with the agencies concerned and said that it was "not acceptable to take out frontline services to people in need of respite when we continue to see considerable spend in term of foreign travel etc"