THE CHIEF executive of the Health Service Executive (HSE) Prof Brendan Drumm has warned that a number of smaller accident and emergency departments around the country may have to be closed if expenditure cannot be brought under control by other means.
It is understood that under proposals currently being examined, the operation of some hospital wards may also be restricted, while some units may close over the summer.
Prof Drumm also indicated yesterday that if the HSE's controversial €100 million cost-saving plan for the pharmacy sector did not go ahead, the money would have to be taken from frontline health services.
Prof Drumm told an Oireachtas committee yesterday that the HSE was facing a €300 million "challenge" in the current year. He warned that this figure could go higher if spending on demand-led community drug schemes increased over budget later in the year.
Prof Drumm told The Irish Timesthat the HSE was looking at a number of areas to reduce expenditure in the coming months. These included levels of spending on travel and telephone services.
It is understood that the HSE will also be examining the overall level of absenteeism in the organisation.
The HSE believes that a reduction in absenteeism levels could save money spent on paying agencies to provide replacement personnel. However, Prof Drumm said that if savings were not made, the HSE would be examining issues such as the operation of accident and emergency units in smaller hospitals.
He said that the HSE would also be looking at other units that were not considered to be providing the best services for patients.
Prof Drumm added that the HSE could look at whether some hospital wards could be restricted to five-day operations rather than seven days.
He also said that it would consider the closure of some hospital units over the summer to allow staff to take leave.
The Irish Times revealed last month that the HSE had warned the Department of Health privately that its official budget for the year was about €300 million less than the amount necessary to provide the same level of services as last year.
Prof Drumm also signalled in a confidential briefing for senior trade union leaders earlier this week that the HSE was considering cutbacks of around €300 million.
Meanwhile, Prof Drumm yesterday also strongly defended the controversial reduction in margins to pharmaceutical wholesalers, which has led to a row with pharmacists.
Pharmacists are paid fees for dispensing drugs under the medical card scheme They also have a mark-up on products provided under the drug payment scheme. However, they fear that under the new HSE pricing scheme for wholesalers, they will be left paying more for drugs than they actually receive in reimbursement from the State. Minister for Health Mary Harney said pharmacists in the Republic were paid about €100,000 more per year than their counterparts in Northern Ireland.
She said that it also cost the State €600 million to bring drugs from the factory gate to the patient. "Nobody could justify that," she said .
Prof Drumm said he would be perfectly happy for the HSE to move out of any involvement with the wholesale drugs market. He warned, however, that if the cost-saving plan did not go ahead, the savings needed would have to come from " frontline services".
