The health service will have to make savings of €633 million this year if it is to stay within its authorised annual budget, the Cabinet will be told this week.
Among the proposals advanced in a new plan will be reducing prices paid by the HSE for goods and services and changes to staff work practices “with an increase in evening and weekend activity to deliver more health services over seven days”.
The plan, to be brought to Cabinet on Tuesday by Minister for Health Jennifer Carroll MacNeill, calls for full implementation of the new public-only contract for hospital consultants that would see more medical specialists delivering services in the evenings and weekends and the winding down of private healthcare on public sites.
The plan proposes maximising workforce efficiency by rostering personnel across five out of any seven days and providing services to the public over the full week.
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It says there should be “effective performance management starting with senior/executive level and consultants”.
The plan proposes cutting spending in areas such as medical and surgical supplies, laboratory services and postage. It also aims for a reduction in the cost of care at the HSE’s long-term residential facilities and other savings by way of an increase in the use of generic drugs.
It suggests exploring whether tenders for cleaning and security services can be revised.
It also proposes cutting back on travel and subsistence expenditure. It says non-clinical travel is to be replaced, as much as possible, by online meetings, trainings and webinars.
The plan proposes a review of a scheme that allows general practitioners to have access to diagnostic tests for their patients.
It advises there should be a focus on an increase in costs arising from GP access to the diagnostics initiative and “whether it has led to over-referral for tests, and what procedures or clinical guidelines can be put in place to ensure value for money in this area”.
The plan recommends a greater roll-out of “virtual wards”, which involve patients receiving acute care, monitoring and treatment at home rather than in hospitals.
The HSE has a record €26 billion budget this year. However, the plan says an improvement in productivity and increased savings are crucial to the health service staying within spending limits.
The plan says the taskforce on savings and productivity has a two-fold focus: a reduction in costs where possible and the maximisation of resources.
It calls for increases in average numbers of outpatient appointments per consultant and measures to reduce expenditure on more expensive staff provided by agencies.
The plan says the HSE will be asked to make additional savings of €382 million this year on top of €251 million recorded last year.
For the HSE to remain within budget, cumulative savings of €633 million are needed, it says.
It proposes widening the use of robotic process automation and intelligent automation in waiting lists to allow resources to be redeployed. The HSE should also establish an artificial intelligence (AI) and automation centre of excellence to assess the safe and ethical use of these technologies.
AI should be implemented in clinical and administrative services, it says.
