Mr Cathal Magee - HSE CEO

UP TO 600 public nursing home beds are to close, more acute hospital beds will shut and there will be cuts to community, mental health and disability services under the Health Service Executive’s service plan for the year, which was published yesterday.

Overall health spending is to be reduced by €750 million in the year ahead, which HSE chief executive Cathal Magee acknowledged would affect frontline services for patients.

The HSE has sought to mitigate the effect of the cuts by putting in place new efficiency measures and work practice changes. However, the effects of budget cuts and scaling back in staffing levels will be felt across the board.

The HSE anticipates that more than 3,300 staff will leave the organisation this year. Mr Magee said that, as 85 per cent of its personnel worked on the front line, this level of resource reduction could not be absorbed without it affecting the delivery system.

As reported by The Irish Times yesterday, a minimum of 555 public beds in community nursing units will close this year and possibly up to 600. Most of these bed closures will be spread across the entire network of community nursing units rather than being concentrated in specific facilities.

However, Mr Magee said a small number of units – “in single digits” – could be considered for total closure.

Acute hospitals will see their budgets drop, on average, by 4.4 per cent on last year. However, when account is taken of existing financial deficits being carried into this year, reduced expenditure of 7.8 per cent will be required.

Mr Magee acknowledged that this would lead to reduced hospital bed capacity but said it was too early to predict the scale of closures.

However, under the plan, even when efficiencies secured under its national clinical programmes are taken into account, the HSE is facing a reduction in hospital activity levels – as measured by the number of people treated – of 3 per cent on average.

The plan also says cuts in hospital activity will hit elective or non-urgent care, although a new maximum target of a nine-month wait for a procedure has been set.

No additional funding has been provided for the national cancer control programme, which will have to deal with a projected 3 per cent increase in incidence of the condition from its own resources.

The roll-out of the planned national bowel cancer screening programme has been put back until the final quarter of the year, due to budgetary pressures.

In relation to services for older people, more than 600 fewer people will be in receipt of home help hours than in 2011. Nationally the level of home help hours provided will be cut by 4.5 per cent.

An additional €35 million is to be invested in mental health services, which will allow for approximately 400 additional staff to be recruited. The investment will be aimed at enhancing child, adolescent and adult community teams as well as suicide prevention and counselling services.

However, mental health services overall will face a budget cut of just under 1 per cent. The plan said there would be cuts in inpatient mental health beds in line with the Government’s overall reform programme while there would also be reductions in payments to external agencies.

An additional €20 million is being allocated to primary care services “to fill as many vacancies as possible and to expand existing arrangements where sessional services are provided by allied health professionals”. However, under the plan cost efficiencies of 2.3 per cent are required in primary care, while a target of securing €124 million in savings has been set, mainly on drug prescribing changes.

An additional 1,270 places are to be made available under the “Fair Deal” nursing home scheme.

MARTIN WALL, Industry Correspondent, Irish Times