Clampdown on cancer care causing €2.7m overspend
A financial review presented to board members by MHB chief executive Paul Gaughan said the overspend was primarily due to the higher costs associated with increased day-to-day activity in the treatment of cancer patients, particularly day-case activity in the oncology speciality, which has already exceeded its planned full year target.
"This is the most expensive day speciality due to the high and increasing cost of cancer drugs," he said.
This follows a clampdown by the Eastern Regional Health Authority earlier this year on the number of patient referrals its hospitals will accept where the service can be provided locally.
"These patients would previously have been treated in Dublin hospitals and while there are clear benefits from having access to local quality services, further investment will be required if local access is to be maximised," Mr Gaughan said.
"The board is now suffering. One patient alone will cost an additional €140,000 in drugs for treatment in Portlaoise General Hospital," he added.
In the area of non-acute care, child residential services pay was overspent due to assaults and high levels of two-to-one cover required for residents at premium and overtime rates. Two children in dedicated and specialised care generated significant expenditure €462,000 for the first seven months of 2003.
The review also said that patient income was unfavourable due to the extension of the medical card scheme to the over-70s and the resultant loss of income.
Expenditure on pay, mainly nursing and junior doctors, was €0.14 million above budget.
The overspend on superannuation amounted to €262,000 due to the continuing high level of unplanned retirements.
Mr Gaughan said the board faced significant challenges in maintaining a balanced budget. Despite setting aside significant contingency funding, the board's expenditure was already running well ahead of budget.
He added that it was also likely that the board would be billed by local authorities in its area during 2003 for rates due on its properties following recent changes in legislation. No funding had been allocated to the board or allowed for in the Service Plan to cover the expected charges in this heading.
It was estimated that a Labour Court pay award for existing and retired nursing staff retrospective to 1975 would cost the board a further €1m which the Department of Health had indicated must be funded from the board's own resources.
To minimise the impact of these over-runs on services, the board has introduced a number of cost reduction initiatives to minimise the likely overspend at the end of the year.
Savings in salary costs were being achieved by either neglecting to fill or delaying in filling most administration vacancies.
Mr Gaughan said that while the board's own initiatives would reduce the overrun on spending over the closing months of the year, it was unlikely that the full overrun could be recovered without additional allocation from the Department of Health.
