Health chiefs in fantasy world
YOU might have missed it, but yesterday millennia of basic maths, science and common sense — which is, as always, uncommon — was found to be based on a tissue of lies. It turns out two minus two is not zero, every action does not have an equal but opposite reaction and you can keep cutting costs without spending less.
Step forward the health service.
Speaking on RTÉ’s Morning Ireland, Tallaght Hospital chief executive Eilish Hardiman — a respected medical expert — said her facility’s need for a €12m overdraft to cover costs until the end of this year did not mean patient care was in danger.
In a polite but clearly frustrated tone, she noted the hospital’s budget had been cut by 9% compared with 2011, despite the fact it was seeing 5% more patients in 2012.
She said patients were now brought in and taken out of hospitals far closer to surgery times, in line with national policy; that agency and overtime levels have been halved at the behest of Health Minister James Reilly; and that the facility will have to sort out its financial problems with further cuts into next year. However, Ms Hardiman said patient care would not be damaged.
It’s not her fault, or that of other hospital managers, and it is understandable she feels the need to back up her own bosses’ claims that black is white, an apple is an orange, and patients will not bear the brunt of cuts.
But to do so is akin to ignoring a reality that is not only affecting Tallaght, but is apparent in every part of the system — an issue that has grown increasingly worse.
Figures up to the end of September show the health service is €374m in the red, a rate that has surged by €45m since August and could hit €500m by December.
While Department of Health and HSE bosses have other scalpel targets up their sleeves — the details of which they demurred on to much controversy at Tuesday evening’s Dáil Public Account Committee meeting — the fact is hospitals make up the vast majority of this overspend.
As such, when it comes to cutbacks, they will be hit the hardest — and patients will inevitably feel the pain, whether that’s directly or indirectly.
When agency and overtime work — issues used to cover holes caused by recruitment bans/freezes/pauses (insert official term here) — are cut in half, as was called for this year, hospital wards will struggle to treat patients with the care they need. Just ask the nurse or junior doctor working up to 100 hours a week next time they go whizzing by to treat another seriously ill patient in an ever growing queue.
However, the hospital overspend crisis is not necessarily the fault of the hospitals.
Facilities are still seeing the same number of patients but with drastically reduced budgets. As such, the overspend problems which in 2007 began in late autumn now occur in April or earlier, with the hospital deficits repeatedly carried over from one year to the next further adding to the issue.
Official statistics show that in Dec 2007, 43 of Ireland’s 51 public hospitals were a total of €152m over-budget — double 2006’s €75.4m rate.
By July this year, the same facilities were €151m in the red.
At the time the 2007 figures were revealed by this newspaper in Sept 2008, the Irish Patients Association urged health chiefs to provide adequate funds for hospitals to prevent spiralling costs in future years.
We’ll let you work out what happened for yourself.
There are improvements in the health service, the reduction in the longest waiting lists being one of them. And there are clear ways to save money without hurting patients. But the facts speak for themselves.
A patient suffered some form of injury or medical error in hospital once every six minutes last year, costing €81m in legal cases, according to the State Claims Agency.
Beaumont (13.3%), the Mid Western Regional in Dooradoyle (18.9%), Galway University Hospital (8.4%), CUH (7.2%), and Tallaght (10.6%), among others, are massively over-budget and need to cut costs.
A recent Government report said older patients are staying too long in hospital because cheaper step-down services are not available — a finding published in the same week as another 450,000 worth of home help hours were axed from the system.
Cuts hurt. And, always, they hurt patients the most. It turns out two minus two does equal zero after all.
