SOME OF the State’s largest hospitals are planning to close wards and cut back on elective surgery in a bid to remain within their budgets for 2009.
Our Lady’s Hospital for Sick Children in Crumlin, Dublin, the State’s largest children’s hospital, plans to close a full ward from the beginning of next month and two other wards for July and August, resulting in more than 7,000 fewer inpatient bed days at the hospital this year.
Documents obtained by The Irish Timesunder the Freedom of Information Act show that Dublin's Beaumont Hospital has similarly drawn up what it is calling a "survival plan" for this year.
The cost-cutting plan for Our Lady’s Hospital for Sick Children refers not only to proposed theatre closures but also to a 15 per cent reduction in day-case activity from May 1st and a 15 per cent reduction in outpatient department activity from May 1st.
This will lead to about 8,000 fewer outpatient attendances at the hospital this year.
The documentation released states that the hospital received €137.9 million in funding this year, but its forecasted expenditure for 2009 is €147.5 million, which would give rise to a deficit at the end of the year of €9.6 million.
In addition, it has a €9.7 million deficit in respect of 2007 still hanging over it.
While the closing of beds and the reduction in activity levels is projected to save €1.158 million, the major savings targeted in the hospital’s “breakeven plan” are cuts in allowances to junior hospital doctors; cuts in agency staffing and in the numbers of staff holding temporary contracts; and in overtime and oncall payments for all staff.
Almost €500,000 is expected to be saved from staff going on voluntary unpaid leave during July and August.
The hospital was ordered in January by the Health Service Executive (HSE) to prepare a breakeven plan.
In his letter to the hospital on January 22nd, John Bulfin, HSE hospital network manager, said: “Your breakeven plan should be based on ELS , and savings should be targeted to ensure frontline patient care services are appropriately maintained.”
The plan for Beaumont Hospital, which faces a funding shortfall of €11.9 million, states that services to patients “will, insofar as possible, be maintained at the current level”.
Savings, it says, will be made by eliminating the use of agency staff in medicine, clinical support and administration; by reducing junior doctors overtime by 10 per cent between February and June and by 20 per cent thereafter; by limiting locum cover for maternity leave to 50 per cent; reducing overtime by catering services, porters and security staff by 20 per cent; reducing overtime in administration by 75 per cent; targeting absenteeism; and reducing internal demand for laboratory tests by introducing “smart testing” protocols.
It also plans to deploy student nurses so as to reduce the requirement for agency staff or overtime; to save money on drugs by switching to generics; severely restrict expenditure on minor capital improvements; to save money on implants and contracts; and it hopes to improve its income through an increase in private/semi-private bed utilisation “from 62 per cent in 2008 to average 70 per cent, with a target of achieving 75 per cent on a monthly basis”.
Dublin’s Mater hospital said it was currently considering its response to its budgetary cut.
The hospital claimed it could not release details of its cost-cutting plan on the basis that it was subject to ongoing negotiations between it and staff representatives.