Patients and their safety seem to have been forgotten in the rush to devise plans to cut costs, writes Eithne Donnellan, Health Correspondent.
Cutbacks in the health service are nothing new. They usually occur late in the year when the HSE, or the health boards before it, begin running out of money.
But talk of proposed cuts in hospital services in January, just weeks into a new financial year, are unheard of.
Not surprisingly, a leaked memo drawn up in the past week by the HSE outlining proposals to cut a range of hospital services in the northeast in order to save money has shocked many.
The proposals include plans to reduce elective surgery and outpatient clinics at hospitals in Navan, Dundalk, Drogheda, Cavan and Monaghan. Bed closures are also planned for Monaghan hospital, which may be taken off call during the year.
While the HSE says no plans have been finalised, it is clear from the memo that the proposals are serious. The person chosen to spearhead the possible implementation of each proposal is outlined clearly in the document.
It was well signalled on Budget day that money would be tighter this year. Minister for Health Mary Harney said "very prudent management" of resources would be required.
In its own service plan for 2008, published just before Christmas, the HSE signalled it would be trying to save €280 million through more efficient and effective management of resources. It stressed it had to live within its €14.1 billion budget rather than recording a huge deficit like it did in 2007.
Looking at the cuts proposed for the northeast one has to wonder if there is any joined-up thinking in the health service. Just days ago Ms Harney was talking with delight about how a new consultants contract had more or less been successfully negotiated and how it would allow hospitals treat more patients over an extended working day.
Now this latest memo talks about cutting outpatient clinics from five days a week to four in the Cavan/Monaghan hospital group and at Our Lady of Lourdes Hospital in Drogheda. And it talks about the establishment of a "shorter working day" at Louth County Hospital in Dundalk.
One also has to wonder who is considering the effect all this will have on patients, already waiting intolerable lengths of time to see consultants. Patients, who will inevitably face longer waiting times if the plan is implemented, seem to have been forgotten in the rush to avoid budget overruns.
These proposals for cost-cutting in the northeast are being conceived against a backdrop of several reports outlining the need to urgently transform health services at hospitals in the region to make them safer for patients. There were plans to recruit about 200 extra staff, among other things, to make this happen. But lack of funding means there are now no guarantees the additional staff will be taken on.
This, combined with news of proposals to cut existing services already struggling to cope, has left hospital staff in the region disillusioned and has led them to warn that patient safety is being put at risk. But is anyone listening?
The northeast meanwhile, is unlikely to be the only HSE region having to come up with a break-even plan. There could be worse to come from other regions.