THE HSE is considering suspending the issuing of new medical cards as part of a raft of drastic measures aimed at breaking even in 2011.
The draft proposals — published in an internal HSE document — also show that it is considering reducing home help hours by 600,000 — or 24% — and removing 400,000 personal assistant hours — a drop of 61% — between now and the end of the year in cuts that will save about €57.5 million.
The HSE is considering not issuing medical cards to a projected 42,044 people under 65 — except in an emergency case — between now and the end of the year in a bid to save €18m.
The document also states that the HSE has issued 84,088 medical cards to under-65s so far this year and anticipates 126,132 will be issued by year end without the cuts being made.
The HSE is also considering suspending medical card reviews and providing no further appliances or aids to patients for the remainder of the year, a move that would save a combined €6.5m.
The document said these measures “are substantial and radical with significant policy and legal implications and will require discussion with the Department of Health before implementation”.
The document comes as the HSE tries to generate savings of over €300m before the end of the year.
In a commentary accompanying its monthly service report for the year to July, the HSE said it was pursuing savings targets of €249m as well as further contingency measures of about €53m to support the delivery of a balanced budget for the year.
The reduction of 600,000 home help hours would produce savings of €11m and the removal of 400,000 personal assistant hours would save €10m.
The document states that the 24% cut in home help hours would result in increased demand on the acute sector and long-stay care or Fair Deal beds; would lead to an increase in the number of delayed discharges and waiting lists; would impact on emergency department/trolley waits; and would impact on the ability to keep older people at home.
In relation to the 61% loss of personal assistant hours, the document says it “will result in increased demand for respite and residential care”.
The draft proposals also put forward the reduction of 200 home care packages, saving €1.1m, and a proposed 2.5% cut in funds to voluntary providers that would produce €9.3m in savings over three months.
The paper acknowledges that the cut to voluntary providers “may impact on services provided by voluntary organisations — potential reduction in day service activity, particularly in rural areas and reduction in activities provided at centres”.
It adds: “These proposals are based on a recognition that it is the responsibility of each budget holder to break even within their service and that any additional break-even proposals do not militate against managers undertaking a fundamental reorganisation of services to deliver on their responsibilities to break even.”
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