‘Cut funds to hospitals that break top-up rules’

The HSE’s “service plan” budget document should allow funding to be cut from hospitals if they fail to address the top-up payments scandal, health bosses have been told.

Health committee chair and Fine Gael TD Jerry Buttimer made the claim as the report — which provides specific details on where the HSE will cut spending in 2014 — was being discussed last night before being sent to Health Minister James Reilly.

As in previous years, the minister has 21 days to either make changes or publish the report in its entirety, paving the way for cuts of at least €666m in the health service over the next 12 months.

However, Mr Buttimer said while the three-week period allows room for manoeuvre, one point that must be included in the final document is a clause warning facilities their funding will be cut if they continue to breach top-up rules.

“When it comes to the service plan, each of these organisations has a service level agreement with the HSE, and that means they should be made to comply with the agreement. The top-ups are from a bygone era.

“I don’t want to make this personal, because some of the people already named are doing tremendous work, but there have been some quite extraordinary sacrifices by those on the frontline and they [managers] must lead by example. There needs to be openness and transparency,” he said.

Senior officials for the Department of Health and HSE would not be drawn on the details in the HSE’s draft document outlining next year’s service cuts. It has already been the subject of two 10-day delays due to the difficulty in slashing at least €666m.

However, it is known that among the key targets of the document are the €113m medical card “probity” drive, a €15m cut to a budget providing free drugs for patients with certain long-term illnesses, and the now annual hospital cuts.

HSE director general Tony O’Brien will be grilled on the document tomorrow when he meets the Dáil Public Accounts Committee (PAC). Both the PAC and the Health Committee have raised concerns over how such significant cutbacks can be achieved.

On RTÉ radio yesterday, Trinity College professor of health policy and management, Charles Normand, said he cannot see how the budget changes can take place without severely damaging patient care.

“I believe there are significant additional savings possible to make within the health system, but it will take much longer than a year to make that possible,” he said, adding that standards will be affected.

Plan talks

HSE and Department of Health officials were locked in last-minute talks last night over the details of the incoming service plan.

At the time of going to press, officials were still discussing the plan to cut at least €666m from the already overstretched system.

The document, which has already suffered a 10-day delay, was expected to be handed to Health Minister James Reilly within office hours yesterday.

The controversial report is expected to be the first order of business at this morning’s Cabinet meeting. As previously revealed by this newspaper, officials from the Department of Public Expenditure and Reform have for the first time this year a significantly increased role in the annual document’s make-up.