HSE budget overruns - Vulnerable should not suffer

The Health Service Executive (HSE) is already failing to meet its 2008 targets and this certainly does not inspire confidence for next year when further cuts are due to be implemented.

Of course, nobody should be surprised, because only last month the Comptroller and Auditor General reported the HSE overran its budget by €245 million in 2007.

It was obvious during the first half of last year that it was exceeding its budget, but no effort was made to cut back, because under the old health board system it was not penalised if it failed to meet its budget. Then, in the second half of the year, the bulk of the savings were made on cuts to services.

At the end of last month the HSE was €118m overbudget, and it is going to have to make cuts to reach its budget target by the end of the year. The convoluted language used in the briefing document recently issued by the HSE to unions certainly does not inspire confidence.

“Expenditure within the HSE is stabilising but not declining,” the author of the document proclaims. In other words, as in 2007, the HSE is not tackling the overrun.

Next month the drug treatment programme at Harristown House in Castlerea, Co Roscommon, is due to be shut down. For the past 10 years it has been treating people with drug and alcohol problems, who would otherwise have been committed to jail.

About two-thirds of those treated there did not reoffend. In a report last year, the Department of Justice stated Harristown House “has an important role to play in treating addiction and tackling crime in Ireland”.

Yet within a year it is being closed down because it is supposedly underperforming. What happened in the interim? Who should people believe — the Department of Justice or the HSE?

Cuts that were introduced as part of the cost-cutting in the employment freeze in 2007 are still in place. If Harristown House was playing an important role, there should be no question of its elimination until a replacement service is up and running.

People with drug and alcohol problems are sick. They need help. Putting them in jail is a costly substitute for treatment that becomes all the more costly because it tends to be so ineffective.

Everybody should accept that cuts in the health budget are necessary, but it should not be the most vulnerable people who will suffer from the cuts. Less bureaucracy would be preferable to less patient care.

Faced with obvious cost overruns in early 2007, the HSE effectively did nothing to curb the overspending, according to the report of the Comptroller and Auditor General. Yet the national directors of the HSE are to be paid a performance-related bonus for 2007.

What is the bonus really being paid for — sheer negligence or gross incompetence? The HSE was effectively holding the most vulnerable people hostage, secure in the knowledge that when cuts hit services to the vulnerable there would be political outrage.

Holding the vulnerable people hostage is the real outrage.