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Speaking of the economy: HSE health cuts. August 30, 2012

Posted by WorldbyStorm in Economy, Irish Politics.

This evening’s announcement of cuts was accompanied by this:

From the HSE.

As part of the overall and unprecedented financial challenge facing the country, the HSE has been set clearly defined budget targets by both the Troika and Government.

In 2010 and 2011 the health services saw unprecedented budget reductions of approximately €1.75 billion. This was followed in 2012 with additional reductions of €750m. These reductions occur at a time when demand for health services continues to grow.

It is well known that the HSE is running a significant budget deficit currently. This deficit exists due to a number of factors, including the increased demand for services. For example, due to increased demand, the HSE has issued 125,000 medical cards over and above Service Plan projections, which is contributing to approximately €100m of the current budget deficit.

The deficit as of 31st August 2012 is €259m. The HSE has a statutory obligation to remain within its allocated budget of €13.2bn for 2012.

Detailed cost containment plans have been in place across the health service since the beginning of the year. However, there has been an increasing demand for services which has contributed in a significant way to the continuing deficit. Should robust cost reduction action not be taken at this juncture, the HSE faces a potential year-end deficit of €500m.

In order to deal with the existing deficit and to remain within budget, the HSE is now obliged to introduce a range of additional cost reduction measures to be implemented throughout the remainder of 2012 and into 2013.

The range of additional measures amounts to €130 million. In compiling these measures, every effort has been taken to target areas that do not impact on direct client/ patient services, with a view to protecting, in as much as is possible, the most essential frontline services. However, it is inevitable that some impact on service delivery will be experienced through the implementation of these measures.

The €130m of cost reduction measures is in addition to other non-operational measures to be undertaken, that have been submitted to the Troika. These non-operational measures include cash acceleration of receipts from health insurers and the transfer of surplus money within the health group of votes such as the NTPF.

Amongst the cost reduction measures included within the €130m are:

€37m through cash and stock management initiatives;

€26.5m through savings in medical equipment (non-capital), furniture, education, training, office expenses, travel and subsistence and advertising;

€35m through reductions in the usage of agency and overtime in line with the targets set in the HSE Service Plan of reductions of 50% in agency and 10% in overtime;

€6m savings on reimbursements for certain products including Glucosamine, Orlistat and Omega-3-Triglycerides;

€10.8m through the reduction of Home Help hours. This involves a reduction of 5.5% from the 11 million hours (€195m budget) provided annually. The impact of these reductions will be minimised by ensuring that services are provided for direct patient care;

€1.7m through the reduction of 200 Home Care Packages per month. This accounts for a reduction of 3.7% from the 5,300 packages (€140m budget) delivered annually. The impact of these reductions will be minimised by achieving greater efficiency in the packages currently provided;

€10.8m through the reduction of Personal Assistant hours from the current €1.4 billion budget for the provision of disability services;

€2m through savings in the procurement of medical equipment. This relates to non-capital equipment only.

Each of the Regional Directors of Operations is working with their staff to develop implementation plans in order to give effect to these measures. While many of the measures are already underway currently, further plans will be developed and discussed with staff and unions over the coming week.

While implementing these plans the health services will at all times attempt to minimise the impact on frontline services and ensure that patient/client quality and safety is maintained to the highest standard possible.


1. CMK - August 30, 2012

10 days ago an unsecured Anglo bondholder was paid 10 million by the state. I didn’t see it on the news, for some strange reason.

That 10 million would have negated the cuts to the Personal Assistant hours or the cuts to Home Help hours. The quality of life for thousands will been compromised and some investment brokerage or merchant bank has gotten back 10 million it probably wrote off in any event.

We have another 600 million being paid out on Monday for an Anglo bondholder and another billion going out on 1 October to an unsecured AIB bondholder. Between next Monday and 1 October another 7.5 million will be paid out to Bank of Ireland unsecured bondholders.

Context, as they say, is everything. To paraphrase Bertie ‘the crash is gettin’ crashier’.


EamonnCork - August 30, 2012

I would like, and I don’t mean this in either a sarcastic or confrontational manner. to hear Nessa Childers’ explanation of how a Labour Party can stand over paying unsecured bondholders while cutting home help hours. Actually I’d like to hear a justification of it from anyone. A sensible justification.


2. Paul Hardy - August 30, 2012

Even the Troika is expressing concern over health service cuts. And to go for the home help service – by a country mile the most cost-effective service in the HSE – is madness.


Nessa Childers - August 30, 2012

I can’t justify it. This may the point that we have reached where we have to choose between compliance and immorality. It is rationing . I am hoping that the Party will be in a uproar. There are also worrying remarks being made by the Troika about medical cards. And CMK, an FTT would raise 500,0000 over five years . What would a wealth tax raise? Does anyone know ?


CMK - August 30, 2012

Nessa, a FTT would raise 500 million here and would be, excuse my phrasing, piss easy to implement. Alas, this government would sooner dynamite Croke Park and outlaw the GAA than introduce a FTT. One of the many deadly and bleak absurdities of living in this state is insistence upon that population’s support for fiscal discipline alongside the same population being told they have to bailout out the profligacy of European banks who lent money to what were obvious dodgy Irish banks. Bleaker absurdity still is the spectacle of SIPTU organising home helps to resist the cuts while financially supporting a political party intent on implementing these same cuts.


RosencrantzisDead - August 30, 2012

It is incredible that the government continues to protect financial institutions and the IFSC even though the state is struggling to to resolve our fiscal difficulties.

PWC came out with a report not so long ago that has us at one of the lowest total tax rates as a percentage of commercial profits in the EU.


When one looks at tax rates, it is difficult to ignore that our corporate tax rates are very low when compared to other industrialised countries. We are going to have to deal with this very soon.


Tawdy - August 31, 2012

While you are hoping, is there any chance at all that you or even any senior member of the labour party would speak out in any publc forum about this?


3. Nessa Childers - August 30, 2012

Here is the reason there is no FTT

We have been making strenuous efforts to gain support or it with some success. There will be a debate in the oireachtas . It is now policy of the EC and EP. Started by the Socialist Group.


RosencrantzisDead - August 30, 2012

I spotted that piece a few days ago. Fair play to you for raising it.


4. Nessa Childers - August 30, 2012

Of course, the IFSC have John Bruton lobbying for them who can present no objective evidence of damage accruing from an FTT. Oh, and then there is Peter Sutherland who has been elevated to the status of a Delphic Oracle.


5. Eugene - August 31, 2012

We sent this out yesterday but got no coverage. Some on the left still do not make the link between the bank bailout & austerity but argue around budget deficits. I think the idea of FTT and the likes are only tinkering at the edges. Social Democracy has made its piece with the system they have long since given up on the “third way.” They are as they say a beaten docket.

“The announcement by the HSE—which in fact is a Government decision—that another €130 million in spending will be cut is a direct result of the forced “bail-out.” As its statement makes clear, the HSE “has been set clearly defined budget targets by both the Troika and Government.” This is nothing more than a direct attack on the elderly, the sick, and the poor.

This year alone the government will hand over to international bankers and wealthy individuals nearly €5 billion in servicing the socialised corporate debt, a debt that is not the people’s debt nor their responsibility. The elderly, the sick and the poor are paying a heavy price.

The government are sacrificing our people and the services they rely upon to feed the avaricious greed of international finance capital. We need a change of direction and a new departure from the current failed economic and social strategy, one that will put the people first.”


6. Jim Monaghan - August 31, 2012

Talking of trade unions the consultants must be happy with the performance of theirs. Perhaps SIPTU could replace Jack O’Connor with either the Gen. Sec. of the Consultants union or the one who negotiated the turning of a bonus into salary of the senior Civil Servants.


7. FergusD - August 31, 2012

I agree with the comments above about these cuts, and theterrible efefct they will have, but I was suprised at this in the statement:

“€6m savings on reimbursements for certain products including Glucosamine, Orlistat and Omega-3-Triglycerides;”

Has the HSE been paying for glucosamine – why? The evidence for efficacy is shaky at best (only positive study carried out by a supplier AFAIK, theoretical justification, based on the biochemistry, for it not there). The Uk’s The National Institute for Health and Clinical Excellence (NICE) has stated that “there is insufficient evidence to support the use of glucosamine in osteoarthritis and recommends that it should not be funded by the NHS”. Omega-3 triglycerides, is the HSE paying for that? Why? Is there an Irish equivalent opf NICE.

Trivial sums though, but surprising to me.


Jim Monaghan - August 31, 2012

I would not be surprised if the HSE was funding homeopathy and the Billings method.Irish Aid is funding the Billings method in Ghana.Oh and Viagra was being provided as well by the HSE.


DerBlutendeRabe - December 9, 2013

@FergusD: “Is there an Irish equivalent of NICE?”

NICE actually does a lot more than the pharmacoeconomics. They produce very sensible and concise guidelines for health professionals.
The NCPE got fucked over Kalydeco IMO. They drug had moderate efficacy in CF but the costs did not justify it (250k per patient per year). Then James Reilly decides to authorize it for reimbursement as a good news story to detract from criticisms made by Roisin Shorthall.

No they dont actually. Also sildenafil is indicted for the treatment
of pulmonary hypertension (its rarish though), as well as impotency. Also what is wrong with people getting sildenafil for impotency through the state? That sort of crap pisses me off. It was prescribed by a medical professional for a condition which is causing the patient distress. Wtf is wrong with that?

Also PCRS rules states that a patient can only get four tablets per week, if receiving it for sexual impotency under the medical card or DPS. So yeah HSE rules state you can only have sex four times a week.


8. Yobbah - September 1, 2012

Minister Reilly says that 70% of the health budget is made up of pay which would, according to my calculations, amount to €9.24 Billion. The total public sector pay (net) according to IMF figures amounts to €14 Billion. Staff in the HSE amounts to 100,000, a third of the public sector workforce. The pay of HSE staff amounts to 66% of the total public sector pay “bill.” Are my calculations correct? Or is Minister Reilly wrong?


9. T.N.B. - September 3, 2012

I did speak to Richard Boyd Barrett some time ago and pleaded with him and almost all parties including Sinn Féin,Joe Higgins and politicians over the last year to please help me in a nightmare situation with HSE Hospitals etc., ever since I was prescribed a Blood Pressure drug and suffered adverse side effects – it is frightening to note that there are so many organisations who speak out but NO ONE for patients being tortured and injured/killed in Irish Hospitals to cover up side effects or incidents – 150,000 patients suffered incidents in irish hospitals in 2010 ALONE – many died others left injured – not one person spoke out – even in the last week – what should have been a simple task/medically – blood pressure monitor placed on my arm for 24 hours – but nurse in this case placed an elasticated tubular bandage under the cuff – ask any doctor what that would do – again further severe injuries by criminals in healthcare and the whole country of politicians and “caring organisations” stay silent.

Who is paying for such a coverup?
Living in Ireland….born in Ireland…an Irish Native’s dilemma on an Irish cover up!

If I were an asylum seeker I would have the protection of The Irish Human Rights Organisation and the Department of Foreign Affairs as well as many other Groups of Justice and Human Rights….

If I were a member of the Travelling Community I would have the protection of Pavee Point, Equality and Justice, Irish Human Rights and many other such Groups….

If I were a prostitute I would have the protection of Ruhama, Women’s Aid and many other such Groups…

If I were a victim of torture from a foreign country I would have the protection of Irish Human Rights, The Red Cross and many other such Groups….

If I were a victim of domestic violence I would have the protection of Women’s Aid, the Gardai and many other such Groups…

If I were a victim of Corporate corruption I would have the aid and support of Transparency Ireland and other Groups…

But as a patient who suffered adverse side effects of a blood pressure drug that I should never have been prescribed I have no support….I am shunned like a leper by the Department of Health, HIQA, ISQSH, the HSE and every HSE doctor, public hospital and by many Groups who profess to speak up for the oppressed and wronged in Irish Society….to be shunned I could deal with but I have suffered systematic torture at the hands of doctors in our hospitals and GPs…with the full knowledge of Prime Minister and Minister of Health….is this pharma control?…all to silence me on what is a worldwide exposure of a blood pressure drug, Rasilez Aliskiren….google it and see what you find. Doctors are harming and killing patients to cover up side effects of drugs in general medicine and psychiatary. HSE give 20% bonuses to consultants to “push” drugs on patients. We did not listen to Susie Long when she spoke out against the two tiered Health System in this country. We did not listen to Leonie Fennell when she spoke out against doctors in our country pushing anti-depressant drugs on our young people…will you listen to me?

Fact: It is not compulsory for doctors or hospitals to report adverse side effects of prescription drugs to the Irish Medicines Board…why? Pharmaceutical companies state that they rely on doctors to report side effects so that they can improve on their drugs. Novartis Medical Director stated to me that he would do what he could both ethically and morally in what has happened to me….and still they harmed me further…should I believe him? Is this the HSE? Is it the Department of Health? Is it doctors and hospitals believing that because they have the protection of the HSE, the IMO, Consultant Groups and their Medical Schools. Write to the Medical Council so many told me and I did only too find out that the Medical Council protects them also….the words of one GP echo in my head “The Medical Council will do nothing on this”. Doctors in our hospitals truly believe they are above the law? Is it pharma control? Or is it a combination of all of the foregoing? Whatever it is, it is wrong, it is beyond medical malpractice. Is this the new Irish holocaust? Yes, I may be labelled “paranoid”…I have found abusing the Mental Health Act comes easy to doctors covering up side effects of all prescription drugs.

We the innocent people of Pharma/HSE/ and Government may suffer but I pray for the many students who study to become doctors and healers only to become puppets in fear!

I appeal to good doctors who care about patients’ health and nurses who no longer wish to part of such torture to patients to step forward, speak out and “Stop the hurting of innocent patients”.

“Those who prefer to favour freedom and yet deprecate agitation are people who want crops without ploughing up the ground. Power concedes nothing without a struggle. It never has and it never will.” Frederick Douglas

“When Liberty and Democracy become unholy, innocent blood like red dye drips from their hands” – Mahatma Gandhi


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