The HSE officials gave details yesterday of how they intend working within a budget that is more than €600m down on last year, stressing efficiency drives would enable them to deliver services without diminishing standards.
While admitting they faced challenges because of the financial constraints, they claimed they could actually improve people’s experiences of the health care system through a range of new initiatives.
They are working this year with an overall budget of €12.6bn, after the allocation for the newly formed Child and Family Agency has been separated out, to run a service with a workforce of almost 98,000.
Heavy reliance on the payroll savings identified in the Haddington Road Agreement was evident in the presentations by the five divisional heads of services who set out their spending plans.
Ian Carter, HSE national director for acute services, which accounts for the biggest chunk of funding at €3.7bn — down €200m on last year — said some of the budget reduction was possible because of Haddington Road.
“So there is no effect [on services]. Whilst there has been a salary reduction, paying for that is the individual. In terms of the actual employment numbers, it actually has no direct impact on the workforce.”
Mr Carter said savings would also be achieved by cutting hospital appointment numbers — again without affecting standards of care.
“We could be slicker and better in terms of the way we see patients.”
He said a best practice target of two follow-up appointments for every initial patient visit had been set which would be a reduction on the current rate of 2.6 follow-ups for every first visit.
But the idea that appointments could be reduced without affecting care was dismissed by Fianna Fáil health spokesman Billy Kelleher, who said the €200m budget cut would hit patients hard.
“This can only compromise patient care. We have heard much from medical professionals in recent months on how patient safety is being jeopardised daily in our emergency departments and Minister [James] Reilly has failed to take action and secure the necessary funding at Cabinet for the health services.”
John Hennessy, national director of the primary care division, which has a budget of €3.3bn this year — down €178m on last year — said he would manage the savings despite allocating €37m to the new free GP visit card for under sixes due to be introduced this year.
Among the targeted savings he highlighted are €50m through the substitution of generic drugs for branded forms, and €20m through more “cost-effective prescribing” by GPs.
Pat Healy, national director of social care, said €20m of the €31.3m in savings he must make to stay within his €3.06bn budget would come from Haddington Road.
The mental health services division is getting an increase in funding this year — up from €757.9m to €765.8m — but is still targeting savings of €9.5m from Haddington Road.
The health and wellbeing division, which is taking charge of health promotion, screening and preventative healthcare, has a budget of €227m this year.