THE HEALTH budget will be cut by €1.4 billion between now and 2014 under the National Recovery Plan. It will be slashed by €746 million next year and “additional savings of €680 million will need to be implemented” between 2012 and 2014, it says.
The Government will seek to ensure frontline health services “are protected from cutbacks due to the need to provide these services and the importance of human capital as an essential condition for economic recovery”.
But it says significant savings must be found from major drivers of spending including free or subsidised medical care and treatment.
“The traditional model of completely free provision for public services is not sustainable. A reasonable co-payment on the part of the citizen will offset to some extent exchequer costs involved and lessen waste arising from unnecessary oversupply, which is always a risk when goods or services are provided free,” it adds.
It envisages current spending on health dropping from €14.8 billion this year to €14.1 billion next year and then sliding to €13.9 billion in 2012 and to €13.7 billion in 2013 and 2014. Overall this represents an 8 per cent cut in current spending over the lifetime of the recovery plan.
In terms of next year’s health budget, the report envisages €259 million of the €746 million which has to be cut in 2011 coming from pay as a result of the reduction in staff numbers following the HSE voluntary redundancy and early retirement schemes as well as cuts in overtime and other non-pay areas.
A further €444 million is to be saved in the areas of procurement and on demand-led schemes such as the medical card scheme and the drug refund scheme, while €7.5 million is to be saved on administration. Another €36 million is to be cut from funding to the Department of Health for its agencies including voluntary bodies and in cuts to the office of the Minister for Children.
The plan envisages much of the cuts in day-to-day spending at hospital level coming from increased use of day-care procedures; reducing patients’ average length of stay in hospital and better bed management. More services will be provided in community settings. “This will lead to a reduction in the number of in-patient beds.” There will be further increases in the charges for private and semi-private treatment in public hospitals “to achieve full cost recovery”.
At the level of community schemes there will be changes in the existing range of dental services and supports “in order to improve access to essential dental services for those most in need”,
There will also be “the introduction of an approach to community support for older people which takes need and financial means into account on a nationally consistent basis”.
Across the health system staff will work over an extended day from 8am to 8pm, existing roster arrangements will be reviewed, staff will be redeployed within and across locations. The plan also says accountability for management and other grades in the health sector will be strengthened.
In addition, it says competition in the professions will be promoted and overseen by an independent figure, reporting regularly to Government.
Elsewhere, the plan says the moratorium on recruitment in the health sector will continue except for essential posts. There will be a 10 per cent pay cut for all new entrants to the public service including the health service. This will apply to nurses and other professionals including hospital consultants.
Numbers employed in public health will fall from 106,850 this year to 100,800 by 2014. This will bring staff numbers to 2005 levels.
Health 2011-2014
2011
– Day-to-day spending to be cut by €746mto €14.1bn, downfrom €14.8bn this year
– Details of cuts and charges to be announced on budget day
2012-2014
– An additional cut of €680mon day-to-day spending. By 2014, the health budget will drop to €13.7bn
– Numbers of staff working will drop to 100,800 by 2014, downfrom 106,850 this year
– Further increases in charges for private/semi-private treatment in public hospitals, clinical guidelines to improve prescribing behaviours, a system of graduated benefits or entitlements and changes in dentalschemes are envisaged