Despite all the assurances to the contrary, patients will undoubtedly suffer, writes EITHNE DONNELLAN, Health Correspondent
MINISTER FOR Health Mary Harney indicated last month that spending on health next year could be cut by up to €1 billion.
As it happens, the actual cut in the health budget for 2011, revealed in the four-year national recovery plan published yesterday, is somewhat less than this, at €746 million.
This is cold comfort though as next years’s budget cut will be followed by a further €680 million reduction in health spending between 2012 and 2014. Despite all the assurances to the contrary, patients will undoubtedly suffer.
Already there are more than 1,000 acute hospital beds closed; the moratorium on recruitment has left many services, including mental health services, short- staffed. To date this year there have been swingeing cuts in home-help hours to vulnerable families across the State.
The recovery plan says the Government will seek to ensure that frontline services are protected from cutbacks, but we’ve heard all that before. While patients needing emergency care are usually looked after, those seeking admission to hospital for elective care are likely to find access more difficult in future.
As a result of this year’s cuts alone, patients have reported that operations for which they were psyched up and had taken time off work have been deferred because of the numbers of closed beds.
More hospital beds will close under the recovery plan. While the intention in the plan is for more care to be provided instead in the community and through primary care teams, we’ve heard that before too. Hundreds of primary care teams have been promised for years – 600 were due to be appointed by 2011 – but they are slow in development. Patients’ pockets too are likely to be lighter when the plan is implemented in full.
A system of graduated benefits and co-payments for care is anticipated, which would see patients contributing to the cost of, perhaps, home-care packages and other benefits. Increases in charges for private and semi- private treatment will also, as usual, drive up the cost of private health insurance policies.
Other increases in patient charges next year are also anticipated but these will not be announced until budget day.
Ms Harney said yesterday she was “mindful of the fact that people are under strong financial pressure and therefore . . . would want to minimise any increases that would impact on the public”.
The major crux facing the HSE in trying to achieve savings in the coming year, is that, unlike last year, it will not be able to achieve the bulk of them from cutting the core pay of its 100,000-plus staff.
Savings will be made though as a result of the departure of those who have opted for its voluntary redundancy and early retirement schemes.
Non-core pay such as overtime costs, which amounts to about €1 billion a year in health, will be a major target for cuts. It is hoped these can be achieved through changed rosters implemented as part of the Croke Park deal.
Ms Harney, who is thought unlikely to stand in the spring general election, said yesterday she hoped a big proportion of the savings could be achieved on procurement costs which amount to about €5 billion a year.
Nearly €2 billion of this is drugs costs which will be reduced through greater use of generic drugs. Another chunk will have to come from demand-led schemes.
“I believe the HSE has the capacity to be able to make these kind of savings without unduly affecting services to patients,” she said.