Claims that patients will not suffer in the latest round of health cuts have been discounted by many, reports Genevieve Carbery
DESPITE HEALTH service budgets having to provide almost one-third of the €440 million in cuts announced by the Government last week, Minister for Health Mary Harney insisted the move "would not affect the provision of health services to patients and clients".
However, included in the €144 million health savings which were outlined was money which was due to be spent on services for older people, those with disabilities and children. So will the old and the vulnerable be the first to feel the health cuts, as claimed by Opposition politicians?
"There is no way to explain that this is not going to impact on patients," Stephen McMahon of the Irish Patients' Association (IPA) said. "We can't deny the reality that this will take fuel out of the life boat and will have a big impact on some patients," he said.
And in coming days the HSE, which has to make savings of another €300 million this year, is due to outline to unions what extra measures it will take to achieve this target. Already the HSE, which has been ordered to live within its budget this year, recorded a deficit of €147 million in the first six months of 2008. At this stage its hospitals have been looking at ways of scaling back on services. Details of plans for ward closures have already leaked out.
Meanwhile, in terms of the Government cuts announced last week, some €85 million is being saved by deferring the 'fair deal' scheme for financing long-term nursing home care.
The plan, announced a year and a half ago, would see the State recouping some long-term care costs by taking a percentage of patients' assets after their death. In addition, a cut of €8 million originally earmarked for the development of new community services for older people will be held over until 2009.
"This has left a lot of people with family members in nursing homes in limbo as they placed them there in the expectation of the 'fair deal' coming in," Gerry Scully, Age Action spokesman, said. "A lot of families are now struggling to find the fees. In Dublin you won't get a nursing home for less than €1,000 per week," he said, estimating that a lot of families are paying €250-€500 per week, depending on the pension and subvention they are receiving. Many families were expecting the 'fair deal' payments to be backdated to January so this is a "double whammy", Mr Scully said.
Most families struggling with nursing home fees will not have the option of caring for relatives at home, so they may have to sell the older person's house or "if they can't pay the fees they will be asked to leave", he said.
The decision is a "real slap in the face for families", according to Fine Gael health spokesman Dr James Reilly. A man in his constituency sold his mother's house and paid €300,000 in nursing home fees over the past five years. "He now has no money left in the kitty and is at a loss as to how his mother is to be cared for," Dr Reilly said.
Tadhg Daly of Nursing Homes Ireland said it was unacceptable that older people would be at the frontline of cuts.
Home care packages, which help many older people to live independently, may be affected by the €8 million being held from older people's community services. "These services were already suffering," according to Mr Scully. Without services such as home help, meals on wheels and occupational therapy, people would be forced to move into nursing homes, he said.
A deferral of some €17 million of a planned €50 million for new disability services was also announced by the Government last week. This is on top of previous cuts announced for the disability sector including 1 per cent efficiency savings worth some €25 million and a carry-over cut of €45 million announced in the last budget.
Inclusion Ireland, an advocacy group for people with intellectual disabilities, has lately received a lot more letters than usual from concerned families worried about the future of services, according to Deirdre Carroll, its chief executive.
She is particularly concerned about services for young people with intellectual disabilities who are over 21 and have just finished three years of training. Usually they would go to supported employment or day care services, but it is unclear if there will be places for them, she said.
If there are no places, many young people would "end up sitting at home or going into more traditional workshops", she said. "They would deteriorate badly if left at home, as happened a lot in the 1980s," she added, describing it as a "backward step".
Labour's health spokeswoman, Jan O'Sullivan, said the most concerned calls she received were about the cut in disability development money. "There is particular uncertainty about young people with intellectual disabilities coming out of school and expecting to go into training programmes in September," she said.
Group housing schemes for adults with intellectual disabilities were also not being used, according to Inclusion Ireland. "There are group homes around the country which have been built and set up but have nobody living in them because of the revenue implications of staffing and running them," Ms Carroll said.
As a result, she said many people with intellectual disabilities have to continue to live with elderly parents who may get sick, or stay in some old-fashioned near-Dickensian institutions.
Ms Carroll expects much of the funding that is released this year for new services will be used to provide places for emergency cases, such as accommodation for people with intellectual disabilities whose parents have died.
Inclusion Ireland's advocacy service was also cut last week following an announcement by Social and Family Affairs Minister Mary Hanafin. Deirdre Carroll described the cut as a great disappointment as it "can provide enormous benefit to one of the most vulnerable groups in Irish society".
And funding for new primary child immunisation programmes, which were being expanded to include Hepatitis B and pneumococcal vaccines, have been cut by over a fifth (€4 million). This is of "grave concern" to Stephen McMahon of the IPA. "Who is making decisions about which children are not getting vaccines?" he asked.
In addition to the health savings announced at Government level, the National Centre for Medical Genetics (NCMG) on the grounds of Our Lady's Hospital for Sick Children in Crumlin, Dublin, said it had to suspend five different types of test due to funding problems.
Many of these tests will now have to be sent abroad. From a patient's point of view, this means more uncertainty, delays in getting results and it may even deter people from getting the tests, according to Prof Andrew Green of the NCMG.
Plans to reduce services at Galway's University College Hospital and Merlin Park Regional Hospital have also been revealed to unions. An orthopedic ward, a medical ward and gynaecology ward will close for a period resulting in patients waiting for procedures.
The cuts would have a devastating effect on patients, Denis Rohan of the Impact trade union said. "The simple message from the HSE is this: If you live in Galway, don't get sick this summer," he said.
However, the hospital said that elective procedures were usually scaled back over the summer as the hospital was not usually as busy during these months.
"Delays in access to routine treatments can turn today's elective surgery into tomorrow's emergency procedure," Jim Reilly, development officer with Patient Focus, warned.