Two of the State's largest hospitals are facing severe funding difficulties as the Government warns of a "difficult year" ahead for acute hospitals.
The Dáil heard yesterday that Dublin's Beaumont Hospital was considering limiting cancer treatment and kidney dialysis services in order to cut costs.
However, The Irish Times has learned that the Mater Hospital in Dublin is also confronted with severe budgetary difficulties and is facing an effective 12 per cent cut in funding for 2003. This could result in up to 11,000 fewer treatments being offered to patients at the hospital.
Sources in the hospital have said there is concern that the level of cuts it faces are similar to those implemented in the 1980s.
While the Mater has yet to finalise its service plan with the Eastern Regional Health Authority (ERHA), it is understood that a recruitment freeze, including a ban on additional front-line staff, will be implemented.
The hospital is also considering reducing its laboratory and X-ray costs by curtailing the service it offers to GPs and patients in the community. It also plans to cut the use of agency staff, which would effectively reduce the number of nurses it employs.
The reduction in the number of treatments offered to patients would impact on both day cases and in-patient procedures, according to a hospital source, and could lead to ward closures.
If the funding difficulties facing the Dublin hospitals were to affect other acute hospitals throughout the State, then the public health system will be unable to maintain services at present levels.
The Minister of State for Health, Mr Brian Lenihan, said the "many competing demands for funding" made "difficult decisions" necessary. He stressed there had been a 9 per cent increase in health spending for this year, but conceded that increases in health funding would be "limited" in 2003.
He was speaking during a Dáil adjournment debate on an internal Beaumont Hospital memo which said it was considering dramatic cuts in services. These may include cancer and dialysis services as well as staffing levels in order to cut 10 per cent off its operating costs this year.
The hospital started the year with a €5.9 million deficit from last year, and needs to cut spending by 10 per cent to live within its allocation for 2003.
The confidential document sent to senior management last week warns Beaumont will have a €21 million shortfall by the end of 2003 if it does not make cuts.
The memo, details of which were revealed by the Labour Party leader, Mr Pat Rabbitte, in the Dáil yesterday, suggests a wide range of measures.
They include closing 35 beds, restricting the recruitment of new and replacement staff, reducing overtime, returning nursing home patients to the acute hospital and postponing some capital development projects.
Other proposals include the reduction of professional fees, closing the night-time dialysis shift and reducing the on-call pathology and radiology services. A consultant kidney specialist at the hospital, Mr Peter Conlon, said yesterday that if the night-time dialysis shift ended 60 to 70 patients would have no means of getting dialysis and would probably die. For this reason, he said he did not believe such a cut would be implemented.
Mr Lenihan said no decisions had been taken at this stage to make any cuts, and that these proposals had yet to be discussed between the hospital management and the ERHA. However a separate memo from Beaumont's clinical services co-ordinator, Ms Ginny Hanrahan, sent to colleagues a week ago, warned: "The likelihood is that many of the initiatives will have to be carried out".