Leaked HSE study: ‘brutal’ cuts must end

The era of "brutal" health cuts must end now and be replaced by multi-year budget hikes or a cross-party review of spending to ensure a "realistic minimal" funding plan can be drawn up.

The drastic call has been made by an unpublished HSE internal report into the ongoing financial crisis that is continuing to damage the system and is central to the medical cards, waiting lists, hospital bed closures and disability cutbacks scandals.

According to the leaked document, which despite being written in March has only emerged as the final details of Budget 2015 are being discussed, cuts euphemistically described as “performance and productivity gains” have now “run their course”.

These reductions, the document noted, have often been imposed in an “arbitrary” fashion and with little knowledge of the impact — both medical and financial, the policy has on the system in the medium-term.

Due to the “brutal fiscal consolidation”, the report said Ireland’s health spending had reduced to a far greater extent than other nations facing similar financial difficulties, or even the social protection or education systems in this country.

The report, which was obtained by RTÉ News, further said that the Government’s current cutbacks policy for the health service, which has followed a previous policy in place since late 2006, is “not sensitive” to the risks involved.

Noting the “contradictory” nature of the policy, it said the reductions in staff numbers alone meant most of the savings from the plan were cancelled out by the cost of bringing in short-term agency workers, and by the impact on patients’ medium to long-term health.

The report said alternative options would be for a cross-party review of health spending to be established to ensure there was a “realistic minimal baseline” for the service, or for a target percentage of GDP to be reserved for the sector.

The 40-page document was drawn up by ex-health minister, Dr James Reilly’s then special adviser, Prof Martin Connor in March.

Its emergence just 11 days before Budget 2015 is announced, and as Cabinet continues to debate the finer details of the financial plan, is likely to raise eyebrows among ministerial colleagues.

Like his predecessor Dr Reilly, current Health Minister Leo Varadkar has seen the system’s dwindling budget as one of the key obstacles to genuine health reform since being appointed to the role in July.

He has previously called for a “realistic” health budget, following on from Dr Reilly’s often ignored calls for a money-follows-the-patient financial model, with officials suggesting a €500m increase could be needed for next year to keep the system, whose budget has been slashed by almost 25% since 2007, afloat.

However, Public Expenditure Minister Brendan Howlin has previously insisted health decisions will be made based on “what we can afford”.


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