The HSE is targeting mental health and acute hospitals in Dublin, according to a leaked document outlining how it will cut €130m nationally.
It is proposed that 25 mental health beds would close, affecting, primarily, the Central Mental Hospital and the greater Dublin area. It has also emerged that 20 beds are expected to close at Tallaght hospital, where €2.5m has to be cut by the end of the year.
A leaked HSE document said savings would hit overtime and agency costs. "While the target is aggressive, the hospital is fully committed to delivering it in full through a range of initiatives which include continued/extended bed closures, reductions in premium pay and the elimination of discretionary spend," the document said.
At St Vincent's Hospital, the HSE has warned that although it needs to cut €426,000 by year end, saving €260,000 in the medical department would involve cutting overtime "in all specialities", and result in "possible delay in discharges and consequent pressure in the ED (Emergency Department)".
In relation to the mental health beds, the HSE draft report suggests looking at "removing" the cost of agency catering at the Central Mental Hospital and examining the "potential closure of at least 25 acute mental health beds (across the service locations)".
It says the inpatient services are oversubscribed and run at about "110 per cent, so this will impact on the services' ability to admit patients. The impact of this will require further analysis."
Nearly €2m is to be cut from the budget for home help hours by the end of the year and the number of Home Care Packages is also in the firing line -- 220 are to be removed, but the document warns: "The reduction in home support may increase pressure on families/carers. In addition, the limited ability to provide support to new applicants may negatively affect some people's ability to stay at home."
In the north-east, it is proposed to cut the opening hours of the minor injuries unit in the Louth County Hospital in Dundalk and to cut eight medical beds in Our Lady's Hospital in Navan.
At Our Lady of Lourdes Hospital in Drogheda, the endoscopy unit and day ward will have their opening hours reduced and five beds could close in the gynaecology ward.
Yesterday, Louth Labour TD Gerald Nash said: "These proposals need to be examined carefully. Local HSE management have not identified these proposals as simply a fait accompli."