PATIENTS will bear the brunt of more than €18.5m in financial penalties that are being imposed on some of the most overcrowded hospitals in the country.
The result will be more bed closures, cuts in operations and outpatient clinics, as well as more A&E hardship.
The fines of up to €3.4m per hospital were revealed yesterday, as the HSE unveiled unprecedented cuts of more than €750m.
They are part of a triple whammy for some hospitals, which will suffer spending cuts of up to 7.8pc as they also struggle with huge deficits from 2011.
This will have a potentially serious impact across all services, hitting everyone from newborns to the elderly.
The fines are imposed on hospitals for so-called inefficiencies, where the costs of treating patients with certain illnesses fall below the standard set by other hospitals.
Hospitals that are being disciplined in this way include Our Lady of Lourdes Hospital in Drogheda, Co Louth, Tallaght Hospital in Dublin, the Mater Hospital in Dublin and the National Maternity Hospital.
On top of the fines, a bleak menu of HSE cutbacks outlined in the plan include:
• More than 600 people losing their home help.
• The postponement of the national bowel cancer screening programme, originally due to start this month, until the end of the year.
• A reduction of 7pc in spending in child protection and family support services.
• A 3pc reduction in patients treated in hospitals.
• More than 550 public nursing home beds closed and residents transferred to private homes.
• Fewer daycare services, respite care and personal assistants for people with a disability.
• A reduction in inpatient beds for psychiatric patients.
• 3,300 retirements by March, mostly among medical and nursing staff.
• No increase in home-care packages.
Health Minister James Reilly said yesterday the aim was that no patient would be more than nine months on a surgical waiting list by the end of the year. But it is difficult to see how this will be achieved in light of the bleak scenario outlined by the HSE yesterday.
HSE chief executive Cathal Magee warned that frontline services would suffer and the 2012 shortfall would be more difficult to cope with -- as it comes in the wake of €1.75bn already slashed from health spending in the last two years.
Another 1,270 people will be given nursing home subsidies under the €1bn funding for Fair Deal, but the money could run out during the year.
There is a 2.3pc reduction in the financial allocation for other services for older people this year.