The devil was in the detail as the HSE finally disclosed its cutback plans for Mayo General Hospital this week, which will include cuts in staff numbers through “moratoriums and natural staff turnovers”, reduced working hours for temporary staff (amounting to 7,000 working hours every week off the rosters of 400 temporary staff throughout the region ), bed closures to be achieved through essential-only admissions to hospital with day assessment prioritised and direct cuts on elective surgery that will directly impact on patient waiting times.
While resolutely confirming that there are no plans to shut down Mayo General Hospital — or indeed any hospital in the region — HSE West operations manager John Hennessy did outline a massive cuts plan that is certain to hit both the public and health service staff hugely in the run-up to Christmas.
Providing background information to the crisis, Mr Hennessy revealed that a deficit of €128 million at the beginning of the year had already been reduced to just under €50 million, but that there was a legal obligation to completely clear this debt by end of the year. In order to achieve this a broad range of cutbacks are to be introduced, tackling a number of issues including absenteeism; reduction and control of non-pay related expenses, on-call allowances, and night work premiums; improvement of contract and procurement agreements; increased income to the health service by levying new, additional, or higher charges, including staff car-parking charges; reducing overtime, costs currently costing over €50 million a year, by €4 million; staff reductions devised in a way not to affect job numbers but instead reduced working hours; bed reductions through outpatient over inpatient focused services; staff deployment from centralised administration centres such as Merlin Park to local hospitals; and rostering of staff over 8am to 8pm days without overtime or call-out options, and putting an end to perks such as travel allowances and overnight rates.
Mr Hennessy pointed out that most of the overspend was in the hospitals and not in the Community Care centres. He also added that there existed “an unsatiable demand for health care which, unfortunately, was not met by a limitless budget” and stated that “no hospitals would be exempt from cost controls” and “only as a last resort would the cuts affect patients and frontline services.” He did add, however, that patients should be aware they can appeal for treatment to the National Patient Treatment Plan if left on a waiting list for more than six months
It was also confirmed that, should the designed measures succeed in clearing the 2010 deficit, there would be “no further cutbacks after December”. However it was also emphasised that each area was in charge of its own destiny and had to break even by year end in order for HSE West to clear the books.
Controversy also erupted at the meeting after it emerged that private health insurance companies owed a bad debt of over €10 million to HSE West — now overdue for more than a year — with total insurance payments due amounting to €42 million.
Francis Rogers, HSE West assistant national director, also highlighted that the rate of absenteeism is currently running at five per cent. “If we can reduce this by even one per cent we can save €1 million on costs,” he said.
Frank Murray, HSE West manager over Mayo General Hospital, stated that action taken earlier in the year primarily on non-service related costs had helped tackle the €2.9 million deficit on the books. “We reduced some service and costs and as long as that happens to year end we don’t expect further curtailments, unless there is a crisis such as a Winter Vomiting Bug,” he said. He added that further cuts on the way will relate to reviews of contract catering, contract cleaning and no replacments of student nurses.
Members of HSE West — which is made up of councillors from counties Mayo, Galway, Roscommon, Leitrim, Clare, Donegal, Sligo, Tipperary and Limerick — in attendance at the packed meeting at Merlin Park in Galway on Tuesday last, reacted angrily to the cutbacks, demanding to know the precise effect they would have on their local hospitals.
Mayo representatives at the meeting included Cllr Tom Connolly, Cllr Seamus Weir, Cllr Annie May Reape, and Cllr Austin Francis O’Malley, the latter who criticised Health Minister Mary Harney for “never attending any of the public health service meetings”.
Asking exactly what news he was supposed to return to the worried people of Mayo with from the meeting, Cllr O’Malley then summed it up as amounting to nothing more than the title of a Big Tom song, “You’re coming out the way you came in”.
