Concern was expressed yesterday that health services may have to be cut again this year because money has not been provided for any increase in the number of hospital patients.
The Irish Hospital Consultants Association (IHCA) said the Health Service Executive's (HSE) national service plan provides for the same numbers of patients to be admitted and discharged from hospital in 2008 as it did at the beginning of 2007.
This was despite the fact that the HSE ended up having to treat more patients than it could afford to treat at the end of 2007, which led to the introduction of cost cutting measures.
Martin Varley, assistant secretary general of the IHCA, said the HSE service plan for this year effectively provides for a 2 per cent reduction in inpatient admissions, compared with the 2007 out-turn. This is the equivalent of 12,511 fewer patients being admitted to hospital.
While the HSE says it expects the discrepancy to be made up by more people being treated on a day-case basis, Mr Varley says no account has been taken of the growth in demand for services by a growing population and an ageing population.
Meanwhile, the IHCA says the HSE plan projects outpatient attendances to decline by over 300,000 in 2008, compared with the 2007 figure - a reduction of 11 per cent.
There are already significant numbers of patients waiting years for outpatient appointments across the State, figures published by The Irish Times earlier this week show. It is not uncommon for patients to be waiting two, three or four years for such appointments after being referred by their GP for a specialist opinion, and in a number of instances in the west, patients are on outpatient waiting lists for up to eight years.
The HSE hopes to reduce outpatient attendances next year by reducing numbers of patients having to make return visits as a result of having increased senior decision-making in outpatient departments.
"The IHCA fails to see how increased senior decision-making will be achieved as the number of consultants in 2008 will be the same as 2007," Mr Varley said.
He pointed out that even if a new contract was agreed with consultant representative bodies, which would allow more consultants be appointed, it still takes a significant period of time to appoint new consultants. There would be a significant lead-in time, he said.
Mr Varley also said it was critically important that all frontline medical vacancies are filled without further delay, and that the locum cover for maternity and other leave should be fully provided for, unlike the situation that existed since last September when a ban on recruitment was put in place by the HSE to offset the multimillion euro deficit it was facing.
The HSE has said its ban on recruitment has been lifted but its service plan states control of employee numbers is critical in 2008 if it is to deliver its plan within its €14.1 billion budget.
Responding to the IHCA's comments, a HSE spokeswoman said its service plan for 2008 had been approved by Minister for Health Mary Harney and it was the best plan it could come up with within available resources.