Massive HSE cuts announced

Medical card patients will no longer get anti-obesity drugs free of charge, home help hours will be cut and there will be a big reduction in agency staff and overtime spending under a package of HSE measures aimed at saving €130 million this year.

The HSE has admitted that the savings will have some impact on service delivery to patients. Health unions have already warned that the agency and overtime spend cuts will directly hit patient care, as it will reduce the number of staff available for frontline services.

The health executive has announced a range of measures aimed at cutting back €130 million of its current €259 million deficit. The balance of the deficit, it says will be made up by measures such as the speeding up of payments from health insurers for private beds in public hospitals and the transfer of some surplus money from areas such as the National Treatment Purchase Fund.

As part of the cuts package, the HSE will no longer cover the anti-obesity drug Orlistat under the medical card scheme, so patients who formerly got this on prescription for free will have to pay for it in future. This is the only prescription anti-obesity drug currently available.

The other drugs cut from the medical card scheme are glucosamine, a dietary supplement believed to protect against arthritis, and Omega-3-triglycerides which are used to protect against heart disease. The HSE will save €6 million from this measure, which will affect 50,000 patients currently receiving these products free of charge.

The HSE says in deciding on savings measures in this area it had felt that these products were less cost effective than others and there was less robust evidence on their efficacy. It had removed them to ensure that funds continued to be available for treatments with clear patient benefits.

Officials at a press briefing said targets for cuts in agency and overtime set out in the HSE service plan at the start of the year had not yet been met. There will be a 50% cut in agency spend and a 10% cut in overtime.

Home help hours are to be cut back by a further 600,000 hours, following a cut of 500,000 made earlier this year, while home care packages will be reduced by 200 per month.

The HSE admitted that this may increase the number of 'delayed discharge' elderly patients in acute hospital beds.

Other savings measures include better cash and stock management and savings in medical equipment. The HSE is looking at reducing its €100 million a year energy bill, including cutting back on unnecessary lighting and heat.

The HSE admitted that while cutback measures have been in place since the beginning of this year, there had been an increasing demand for hospital and other services over the past eight months which had increased its deficit, which was heading for €500 million at the end of the year.

Because of this, it had been necessary to implement additional savings measures, which would continue into 2013, the HSE said.

HSE officials admitted today that some of the savings the HSE had hoped to achieve had progressed much more slowly than had been hoped for in its service plan at the start of the year.

The Irish Nurses and Midwives Organisation said the new range of cuts would jeopardise patient safety.

General Secretary Liam Doran told RTÉ News the savings could be achieved without affecting patients if the Government went ahead with its plan for greater generic drug prescribing and charging private patients for public beds.

The HSE has admitted, however, that as these initiatives required legislation and would take some time to implement, they cannot be used to cut its deficit this year. The two items were, however, included in January as projected sources of income in the 2012 HSE service plan, which was approved by Health Minister James Reilly.

Further bed cuts and theatre curtailments are expected to be announced by hospitals around the country in the coming weeks as they attempt to reduce their deficits and implement the agency and overtime cuts.

The HSE has said that while there would be no cuts in overtime rates of pay, as this would breach the current terms of Croke Park, it planned to cut the overall spend on overtime by having fewer staff doing overtime, and on agency staff numbers.

It said previously announced plans to get staff to work more flexibly, including working extra hours, had been shelved until next year.

The HSE said local health managers were developing implementation plans for the cutbacks. Already, bed closures and agency and overtime cuts have been announced in the north-east.

Meanwhile the HSE said today no policy decision had yet been taken on changing medical card eligibility. However, the matter was under review with the Department of Health.

It has been speculated that measures such as means testing for over 70s medical cards may be introduced in the Budget at the behest of the 'Troika'.

Time to tell the Troika where to get off?

[Posted: Thu 30/08/2012]


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