PEOPLE on public waiting lists face longer delays this year as hospitals look set to cut around 54,000 inpatient admissions.
A draft service plan by the Health Service Executive (HSE) -- setting out how it will spend its funding this year -- proposes to cut inpatient admissions of people who need at least one overnight stay from 595,000 to 541,000.
Although it plans to increase the numbers of patients treated on a day-case basis by 769 to 679,510, the closure of beds and reductions in inpatient numbers will inevitably affect waiting lists as well as those needing a bed to have diagnostic tests.
There are currently 18,000 people on waiting lists for inpatient and day-case procedures and more than 6,000 have been delayed for at least six months.
The plan suggests that some of the inpatient cuts will be achieved by diverting more people away from A&E departments to community services.
The board of the HSE will discuss the plan today and can make amendments.
But because of the tight budgetary situation it has little room for manoeuvre.
It must then be handed over to Health Minister Mary Harney who has the power to accept its proposals or change it.
The HSE is to get €14.8bn this year but up to another €1bn will have to be generated from other sources, including pay cuts and increased charges such as the proposed prescription item charge for medical card holders from April.
Around €141m is due to be generated in costs from drug companies but the document reveals HSE concerns about fully realising this source of income. Its budget may also come under pressure from medical negligence payouts and higher sums awarded to people who successfully appeal the money they received under the nursing home repayment scheme.
The agency also estimates that around 1,500 of its staff will retire this year at a cost of €167m from its core budget. It will have to stay within a staff ceiling of 109,600 for 2010 .
Services will also come under pressure from the staff moratorium on recruitment which is increasingly affecting the HSE's ability to deliver care.
Commenting on the proposals, Fine Gael spokesman on health James Reilly said: "It is a travesty to describe this as a service plan when it is in fact a blueprint to cut service to patients in need. In reality this means that more people will be waiting in pain for hip operations, knee procedures, gall bladder operations and pain management .
"Sadly, some with terminal conditions will be left to linger in pain. Many more people waiting for medical investigations to discover if they have a serious illness like cancer will be put on the long finger," he predicted.