Cancer patients in the northeast may have to travel to Dublin for chemotherapy if a plan by the Health Service Executive (HSE) in the region to cut costs is implemented.
The proposal is part of a plan to offset a potential deficit of €9.7 million in the region this year. The HSE has admitted in an internal document that the plan could affect patient safety.
The plan identifies initiatives where potential savings could be made. These include examining the use of private laboratories for tests, not paying overtime to junior doctors outside of agreed rosters, only replacing equipment deemed absolutely necessary, reducing recruitment costs and reducing the use of agency staff.
There is also to be a review of sickness and absenteeism among staff.
The plan identifies in particular how €600,000 allocated for oncology or cancer posts at Our Lady of Lourdes Hospital in Drogheda could be used "to bridge the deficit" if the posts were put on hold.
However the document says the service is at present provided by a sessional oncologist and there are "serious workload issues" due to increased activity in this service over the past five years. "Patient safety could be compromised if the current arrangements are not further developed."
It also states that if the money is used to offset the deficit it could lead to industrial relations unrest and patients requiring chemotherapy possibly having to travel to Dublin.
The document, which has been obtained by the Irish Nurses Organisation, was presented to the HSE by northeast hospital network manager Chris Lyons last week.
It has also spelt out the possibility of not proceeding with additional dialysis shifts at Cavan Hospital. The implications, it said, were increased waiting lists. This could save €230,000.
It examined possibly delaying a planned refurbishment and expansion of the A&E unit at Our Lady of Lourdes Hospital, but said this "would compromise patient safety based on the known risks of the current department and embarrass the HSE".
All new development posts are to be put on hold, all replacement posts are to be thoroughly scrutinised and no new services are to be commenced.
The overall plan, not yet finalised, is calculated to save €6.3 million.
Tony Fitzpatrick, an industrial relations officer with the INO in the northeast, said if the HSE wanted to make cutbacks it should look at "the duplication of roles and managers since the health service reforms were introduced and not at frontline staff".
He was concerned if agency staff numbers were curtailed it would increase the workload of already overstretched staff and affect patient care.
The HSE, in a statement, said hospitals in the northeastwere examining options "to assist in meeting their requirement to operate within the approved funding allocation in the current year".
A number of other HSE regions are also expected to have to make cuts.
The west/northwest hospitals network recorded an overrun of 13 per cent on its budget for the first two months of the year, while the southeastern network had an overrun of 11.4 per cent for the period.
The Dublin south hospital group recorded an overrun of 8.5 per cent over the same period, while the Dublin/midlands hospitals recorded an 8 per cent overrun for the two months in question.