Medical cards are to be removed from 40,000 people and more drugs are to be delisted from the medical card scheme under further swingeing cuts to the health services to take effect this year.
The departure of a further 4,000 health service staff and the introduction of a waiting list for the Fair Deal nursing home scheme for elderly people and their relatives are also envisaged in the 2013 HSE service plan published yesterday.
While the budgets for home help hours and homecare packages are being maintained, this amounts to an effective cut because of growing demand for these services.
Cuts totalling €721 million are being made to the health service budget this year to meet the financial limits imposed on the Government by the troika. At the same time, demographic pressures and growing demand for medical cards and drugs will push existing costs up by €748 million.
The HSE overspent by almost €400 million last year but director designate Tony O'Brien said yesterday he expects the service to keep within its spending targets in 2013.
Financial penalties
Hospitals that fail to keep within budgets will suffer financial penalties.
Funding for hospitals is being increased by 3.5 per cent to ease their financial pressures, but this means the brunt of cuts being directed to medical card schemes and services for the disabled and older people.
Sinn Féin health spokesman Caoimhghín Ó Caoláin claimed the 1.2 per cent cut in disability spending was four times what the sector expected. Funding for older people is being reduced by 2.6 per cent.
The removal of 40,000 medical cards will be done by changing the way income is assessed for eligibility for a card. Details of this and other specific measures will be announced at the end of this month. Most of the anticipated €323 million in savings in primary care spending were made known last year, such as reduced drug costs and an increase in the prescription charge. However, a further €60 million will be saved by removing more drugs from the medical card scheme, savings on high-tech drugs and "probity measures" on medical card and other schemes, it was revealed yesterday.
Spending targets
The HSE's chances of staying within spending targets may well hinge on agreement between the Government and public sector unions on an extension to the Croke Park agreement. The HSE hopes to reduce its pay bill by €286 million this year, through a redundancy scheme and 1,500 normal retirements or departures. However, this sum also includes a projected €150 million in "unallocated" savings from new public service agreements.
The Irish Nurses and Midwives Organisation last night expressed concerns about safe staffing levels with the departure of so many staff from the health service.
The plan includes a number of elements promised last year but not delivered. More than 470 mental health staff are to be appointed and more than 260 primary care posts are being created.
Minister for Health James Reilly, who presented the plan to Cabinet on Tuesday, said 2013 would be a challenging year but the HSE's task was to cut the cost of services without cutting the level or quality.
