Health spending cuts - Savings must not hit most vulnerable

THE Government has to cut back on spending. Inevitably, there will be complaints about the programmes being cut.

Only last month an expert group advised the Department of Health to extend the flu vaccination scheme this winter from those aged 65 and over to everyone over 50.

The Health Service Executive advised doctors that the scheme was being extended, but the HSE has since reversed that decision and written to the doctors that the scheme is not proceeding. The HSE will supposedly review the matter next year.

Last week, the annual report of the Comptroller and Auditor General (C&AG) highlighted how cuts in the HSE’s budget were directed largely against the elderly and patients with mental and physical disabilities. In 2007, the HSE exceeded its budget by €245 million. The over-runs became apparent early in the year, but the C&AG noted that there was a considerable delay in addressing the deficit.

“Despite its initial assessment of the financial position, the HSE senior management team did not direct any specific action at this point to achieve the savings that were likely to be needed to stay within budget,” the report noted. This was damning recognition of the contemptible irresponsibility of management.

The health allocation in the 2007 budget was €13.98 billion, which was about €341m short of what the HSE requested, but it then behaved as if more had been allocated to it. The C&AG noted that past experience under the old health boards had suggested that if budgets were exceeded, hospitals would not be penalised. If they implemented cost savings, however, they would effectively “lose out to other parts of the system which ignored the rules”.

Owing to overspending in the first half of 2007, the HSE was compelled to implement cuts of €208m during the second half. The largest cut was €74m in services to older people. Other savings included €31m in disability services and €22m in mental health services.

Questions should be asked as to why they targeted the most vulnerable. Was it because those people did not have the political clout to fight back?

This week, the story of the late Mary Mulvihill highlighted the last period when major health cuts were being implemented, some 20 years ago. BreastCheck sent her a letter this week, inviting her to a free appointment almost 20 years after her death.

“It doesn’t take guts to confront the old, the sick, and the poor,” Charlie Haughey declared during the 1987 general election campaign. It was the soft option then, and he took it himself in the following months when his government introduced savage health cuts that meant that much of the savings were at the expense of the most vulnerable elements in society.

That was a disgrace then, but it will be even worse if society tolerates the same thing happening again.