Nothing to trim at Ennis hospital

A SENIOR Health Service Executive (HSE) figure has warned the Mid-Western Regional Hospital, Ennis cannot sustain any further cuts.

The defence of the hospital came from none other than the interim reconfiguration medical director for HSE West, Paul Burke. Mr Burke told a briefing for Clare Oireachtas members and HSE Forum members that Ennis hospital is running a very lean operation and there is “no further fat to be trimmed”.
According to Councillor Brian Meaney and Deputy Timmy Dooley, Mr Burke stated Ennis hospital cannot absorb proposed additional budget cuts of around €1 million without impacting on service delivery. He also pointed out that over the last three years, HSE allocations revealed the Mid-West has been significantly underfunded in terms of its budget per capita under the previous Government, compared to other regions.
While Mr Burke acknowledged this is a crude instrument that does not take into account other factors, such as there are more hospitals in Galway City compared with Limerick, this does not explain the whole picture for the disparity. He asked politicians to consider the issue and noted it will take a number of years before the Mid-West budget can be increased incrementally.
In a statement to The Clare Champion, Mr Burke said Ennis and Nenagh have undergone significant changes and lost large numbers of staff over the last two years. He explained the hospitals are now very “fit to purpose” for the work they do and further cuts “are likely to affect services”.
“There are very few areas now where further efficiencies can be made. The introduction of the acute medical programme will lead to changes in the way some medical services are delivered but plans in that area are not yet finalised,” he said.
Already operating on reduced budgets, Ennis and Nenagh hospitals are facing the prospect of having another €1.8m in total taken out of the budgets, according to a HSE plan. The plan warns these cuts would require reduction in services at day surgery and in-patient levels on a seasonal adjusted basis.
The HSE has already approved cuts totalling €6.196m in the Mid-West on items such as travel and transport, agencies reductions, bed management and seasonal theatre closures over a three-month period.
Cuts totalling €8.865m are being considered, such as  €3.915m reduction in agency and overtime; €2.1m in Croom Orthopaedic Hospital; rolling closure of theatre in the Mid-Western Regional Hospital, Limerick, representing €800,000; Nenagh and Ennis budget adjustments of €1.8m and consultant locum costs of €250,000.
The Mid-West HSE said the scale of the challenge facing health services in the Mid-West in 2011 is in the order of €38m.
“It was pointed out at the briefing that containment measures already in place and expected budget adjustments, would still leave a challenge of some €20m. Every effort is being and will continue to be made to reduce the effects on front-line services and plans to achieve this are currently being developed by the HSE,” a spokesman said.
Deputy Michael McNamara said it is regrettable that Mid-West funding was allowed to be reduced under the previous Government, which the present administration will be seeking to address.
Deputy Joe Carey stated Ennis hospital stayed within its budget for the first four months of the year, while Deputy Pat Breen said the introduction of proposed cutbacks of almost €1m in Ennis hospital would threaten its future viability.
Senator Tony Mulcahy stated the HSE will have to find the cost savings from its national budget and highlighted the increase in managerial posts from 2000 to 2010 and the increase in health expenditure without a corresponding improvement in the delivery of services.
Councillor Brian Meaney asked HSE integrated services manager, Bernard Gloster if the HSE has any alternative to proposed cuts of €20m across acute and non-acute services in the Mid-West.
Mr Gloster stated the HSE locally does not have an alternative package of cuts, unless savings could be found in the national HSE budget.
INMO representative, Mary Fogarty claimed assurances were given by the previous health minister that funding would be put in place to support reconfiguration, which didn’t happen. Ms Fogarty said the HSE “put the cart before the horse” when it removed 24-hour emergency services at Ennis and Nenagh hospitals without having the necessary resources in place.
She claimed staff numbers are so limited in Ennis that there isn’t any staff available for redeployment to other hospitals.
Concern about the impact of further cuts in Ennis was also expressed by Councillor Tom McNamara at a regional HSE West Forum meeting, where he stated it seems Ennis is being the worst hit by budget reductions, despite staying within its budget.
Regional director, John Hennessy stated there is no basis to the claim Ennis hospital is being punished for staying within its budget last year. Mr Hennessy said a number of cost-containment measures have been earmarked across a number of acute hospitals in the Mid-West. He stressed the main focus of HSE management is to try to deal with cost-containment measures without impacting on front-line services.