Health service facing cuts of €1bn in 2013-2014

THE HEALTH service is facing further cuts of about €1 billion in funding in 2013-14 while staff numbers will be reduced by an additional 6,500, management told trade unions yesterday.

At a meeting to discuss reforms under the Croke Park agreement, management said that to deal with this situation “demonstrable changes” would be needed to attendance patterns, clinical and non-clinical work practices and reporting relationships.

Management did not table controversial proposals to increase working hours for staff, as had been expected. This had been expected by a number of union leaders who had been prepared to firmly oppose any such plan.

Earlier this year the HSE floated the idea of staff working two extra hours per week for no more pay for a two to three year period.

Among the changes proposed by management yesterday were benchmarking the staffing levels in place in care-for-the-elderly facilities in the Republic with those in the North. It said it also wanted to examine rosters in place for acute nursing and care staff.

Management said there should be a reduction in the hours of non-consultant hospital doctors to ensure further compliance with a European directive on working hours. Management also said that “skill mix options” should be maximised at every level of service delivery. It said there should be greater redeployment of staff on foot of new shared service initiatives. It proposed that this could include a centralised human resources service to cater for the HSE and the agencies it funds.

A document given to the unions said that there would be reduction in numbers of management grades across all disciplines and that management structures would be rationalised with the introduction of new hospital groups and trusts as proposed by Minister for Health James Reilly.

The reform proposals set out in the document are the first to emerge since Taoiseach Enda Kenny asked Ministers to propose reforms to generate extra savings from the Croke Park agreement.

Unions have been asked to draw up a response and further talks will take place next week.

The document said that the complexity of the task of putting the public finances on a sustainable footing was evident to all parties. “The public health service must deal with an effective reduction in resources in 2013-14 of some €1 billion and a reduction in staff numbers of some 6,500 WTE [whole time equivalent] staff .

“A core priority for the Government is sustaining the largest possible quantum of existing service while maintaining essential supports to those dependent on the public health system.

“This will require achieving a more productive match between staffing and service activity levels while safeguarding quality and clinical performance.”