Longer nursing home waiting lists, emergency department closures, a cull of 75,000 medical cards, and cancer screening cancellations all form part of a savage €1bn health service cutback next year.
Doctors and nurses warned that the “austerity charter” would “compromise safety”, while opposition politicians claimed some cuts have little evidence to back them up.
According to the HSE’s 2014 Service Plan, which was published yesterday and details exactly how taxpayers’ money will be spent next year, the system faces just over €1bn in cuts over the coming 12 months.
The figure includes a €619m reduction in 2014 — down from a previously mooted €666m level — and a €419m carry-over from this year caused by hospital overruns and delayed Haddington Road savings.
Among the areas to be hit the hardest will be the nursing home sector, with the HSE admitting waiting lists will increase next year due to funding issues.
Officials said 700 fewer beds will be available under the Fair Deal scheme next year compared to the 2013 target — with Age Action Ireland claiming there is little provision for what will happen to these people — while the Fair Deal budget itself will be cut by €35m.
Up to 75,000 existing medical cards will also be culled, despite the projected €113m cut to hit the sector falling to €23m.
While 60,000 new cards will come on stream, those set to lose out include 25,000 people due to lose the help as part of the HSE’s deeply unpopular “probity” drive, 30,000 over the age of 70, and a further 20,000 who have emigrated, died or no longer qualify.
For the first time, the report does not contain any details on projected discretionary medical card levels.
The drop in the medical card cut from €113m to €23m is partly based on a €60m-plus transfer from the HSE’s planned pension lump sum payments next year — potentially causing a fresh problem over a 3,600-person targeted voluntary redundancy package for 2014.
Some emergency departments are also likely to close next year as part of a €7.5m hospital reconfiguration plan which will mean some services will be needlessly duplicating those nearby, while the rollout of the BreastCheck programme to older women has also been put on hold.
While positive steps such as €3.2m in funding for bilateral cochlear ear implants, €57m for free GP care for under-sixes, and €1.48m for maternity services are also in place, further cuts have been outlined.
They include HSE projections that outpatient and inpatient levels will fall, despite the fact demand for services is increasing every year — an issue which could increase waiting list delays.
Irish Medical Organisation president Dr Matt Sadlier said the report is an “austerity charter”. He was backed by Irish Hospital Consultants’ Association president, Dr Denis McEvoy, who said the targeted inpatient and outpatient drop “compromises safety”.
The Irish Nurses and Midwives Organisation was equally blunt, warning the plan “confirms deeply flawed policy towards the public health service”.
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