Hospital faces axe from crippled HSE
THE closure of an entire hospital, 1,000 redundancies and axing key services are among shock plans to slash costs in one of the struggling health service’s biggest regions.
Despite the funding crisis, independent consultants were paid to give the crippled Health Service Executive (HSE) a menu of options to cut costs if it is to have any chance of reducing a €63m hole in its finances.
Sources said Roscommon County Hospital has been singled out as most likely to close – or face downsizing from its 24- hour, seven-day service.
The Irish Independent has learned the hospital was named in an earlier draft of the report.
Unions have reacted with horror to the drastic plans, saying they go much further than anyone envisaged – particularly the proposed closure.
The revelations come as hundreds of people in Co Donegal gather today to protest against cuts to services at Letterkenny General Hospital, also identified in the report as a target for cutbacks.
The confidential report, obtained by the Irish Independent, says the HSE West cannot realistically break even by the end of the year without immediate radical action.
The document was compiled by UK consultants Mott McDonald, which has an Irish office and which specialises in engineering, education and health consultancy. It has not been disclosed how much they were paid.
The financial problems in the HSE West area are said to be deeper and far more wide-ranging than in other sector in the country. Any cuts would have to be signed off by new HSE boss Cathal Magee.
Consultants identified six sites with the highest financial deficits: University College Hospital, Galway; Mayo General Hospital; Sligo General Hospital; Letterkenny General Hospital; Portiuncula Hospital in Ballinasloe; and the Local Health Office, Galway.
Although it found a deficit of €63m exists, it said the total savings achievable before the end of the year were only between €44m and €54m.
The HSE has already started to act by telling managers not to renew temporary staff contracts.
Among the drastic measures suggested to shore up the gaping financial shortfall are:
- Complete hospital closure.
- Introduction of waiting lists for aids and appliances.
- Redundancies and nonrenewal of the contracts of 1,000 staff.
- The amalgamation of beds in key service areas, including female surgical and gynaecology units.
- The introduction of a centralised laboratory service for the entire region.
- Closing hundreds of beds and slashing elective procedures. The report, based on site visits in early May, said without a radical reduction in the workforce, a host of service cuts will be necessary.
It recommends immediate cuts that would directly affect patients.
The HSE claimed last night the Mott McDonald report was a “tool” or guidance document to assist management in achieving cost savings “to ensure it does not spend money it does not have”.
A spokesperson said it would “form part of the analysis and planning” needed to reach a break-even position at the end of the year.
The consultants recommend closing community nursing units and acute mental health beds, and slashing home help and home care services.
Unions last night claimed the report showed the HSE West was a “basket case”.
The report was given to senior union officials after they demanded it at talks at the Labour Relations Commission on cutbacks earlier this week, claiming they had insufficient detail on the proposals.
It says there is “a significant shortfall” between savings measures set out by the health service in the region and the actual reduction required, and it forecast a deficit of over €107m next year.
“If break-even is to be achieved in 2010, then more radical solutions are required in the way that health services are affected with the resources available,” it said.
It said closing the gap in the medium term “could include the closure of a hospital and the transfer of beds to another site, with the redeployment of permanent staff from and the cessation of temporary staff contracts at each of the sites”.
The ‘Review of Operational Controls and an Assessment of Cost-Containment Measures of HSE West’ also identified numerous areas of overspending.
It pinpointed overtime for nurses and clinical staff, patient transport, and overruns on medicines and leased property.
The report also found government policy to cut costs, was having the opposite effect in some cases.
It found its ban on hiring meant health employers were running up bills recruiting agency and part-time staff to work additional hours at premium rates.
The report says HSE West overspent by €83m last year, which included an acute hospital overspend of €26m, pension overrun of €65m and ambulance overspend of €5m.
However, the revised budget for this year is 12.3pc lower than last year’s.