Hospital Services.

Dáil Éireann Debate, Wednesday - 17 October 2007

Wednesday, 17 October 2007

Questions (70, 71, 72, 73)

Chris Andrews

Question:

138 Deputy Chris Andrews asked the Minister for Health and Children if, in view of the fact that she intends to ensure that the resources of St. Luke’s will be utilised in the best interests of the health services, she will rule out the sale of the St. Luke’s site for private development; and if she will make a statement on the matter. [24061/07]

Written answers

Minister for Health and Children (Deputy Mary Harney)

The transfer of services from St. Luke's Hospital to new facilities at St. James's Hospital is not due to take place for a number of years. In the meantime, two additional linear accelerators will be commissioned at St. Luke's in early 2008 and two replacement linear accelerators will be commissioned later in 2008. These will provide much needed interim capacity pending the roll out of the National Plan for Radiation Oncology. No decisions have yet been taken in relation to the future use of the site and facilities at St. Luke's. However, I intend to ensure that these resources are utilised in the best interest of the health services.

Martin Ferris

Question:

139 Deputy Martin Ferris asked the Minister for Health and Children the discussions she has had with Health Service Executive management regarding cuts in hospital services; and if she will make a statement on the matter. [24058/07]

Aengus Ó Snodaigh

Question:

141 Deputy Aengus Ó Snodaigh asked the Minister for Health and Children if her Department has assessed the effect of Health Service Executive cutbacks on patient care; and if she will make a statement on the matter. [24056/07]

Minister for Health and Children (Deputy Mary Harney)

I propose to take Questions Nos. 139 and 141 together.

I have frequent meetings with the Chairman and Chief Executive of the HSE where financial management and service development are discussed. My Department also has ongoing contact with the HSE on a wide range of subjects. There are close to 130,000 people employed in the delivery of our public health and personal social services the vast majority of whom provide direct service to patients and clients. The current pause in recruitment must be viewed in this context. It is a temporary measure put in place by the HSE to live within its budget. It will be reviewed at the end of October and it is being monitored by the HSE on a week by week basis. I have frequent meetings with the Chairman and Chief Executive of the HSE where financial management and service development are discussed. My Department also has ongoing contact with the HSE on a wide range of subjects.

The HSE must be able to manage within the resources made available to it by Government and voted by the Dáil. It should not come as a surprise to anyone that managing the budget in the health sector means managing staff. Staff costs make up almost 70% of the HSE's overall budget. It is unreasonable to suggest that in a service of this scale, with an employee cohort of this size, that every vacancy which arises must be filled immediately, and, if it is not filled immediately, that dire consequences will result. Living within budget and making the best use of the available resources is an essential task of any sound organisation. Reforming our health system is not just about extra funding and extra posts. It's about ensuring that the extra money which has already been invested by the Government on behalf of the Irish people is being used wisely and is being used efficiently.

Many of the actions taken by the HSE to control its rate of spending in the last three months of this year have demonstrably no effect on front line services and some of the claims made about alleged effects on services are without justification. For example, the cancellation of foreign travel and the release of temporary summer holiday cover staff cannot mean a reduction of services. Claims of this nature should be assessed in the context of the HSE's overall activity levels. For each of the last three months of this year, there will be over 100,000 patients treated as in-patients or on a day case basis in publicly-funded acute hospitals. That will continue to be the case.

However, I would emphasise, and the HSE recognises, the importance of staying within annual budgets and staffing levels, and managing activity throughout the year, so that planned annual service increases are achieved in an orderly manner over the whole year. It is ultimately no service to patients for hospitals or any other cost centres to over-run budgets and staffing levels in the early part of the year, causing a slowdown of activity in their own service or in any other service later on. Any postponement of an operation or service arising is naturally very disappointing to individual patients and clients.

John Perry

Question:

140 Deputy John Perry asked the Minister for Health and Children the amounts by which each hospital has overspent their budget as at end of September 2007; if she is still confident that the recruitment ban and cutbacks will not affect frontline services; and if she will make a statement on the matter. [24081/07]

Minister for Health and Children (Deputy Mary Harney)

The latest reports available to me from the HSE, for the period to end August 2007 show that overall the National Hospital Office is some €162m in excess of its period budget. The table gives details of the spend of each hospital against its agreed budget. Those hospitals with the highest overspend include Kilcreene Orthopaedic Hospital, Our Lady's Hospital Navan and Portlaoise General Hospital. It is also worth noting the hospitals that are staying within, or very close to their budgets, e.g. the Regional in Dooradoyle, Limerick, Holles Street and Waterford Regional. It is very clear that if every hospital performed as efficiently as the best we would achieve both better cost control and better services.

Professor Drumm has informed his board that, through a combination of some additional funding and remedial measures, he is aiming for a break-even position in 2007. The statistics on hospital activity to end August indicate the overall the targets set in the Service Plan for the National Hospital Office in 2007 are some 2 — 5% up for In-patient Services, 4.1% for Day Cases and 7.5% for Out-patients. The measures are aimed at discretionary spending in the first instance, suspension of recruitment for a specified period and at bringing back activity to target or funded levels activity. The measures are subject to a continuous review by the HSE National Hospital Office.

In the event that these measures are not sufficient to achieve a financial break-even, it may be necessary to implement additional measures, given the statutory responsibility of the Accounting Officer to contain spending to the level approved by Dáil Éireann.

Extract from HSE Performance Monitoring Report (PMR), August 2007

National Hospitals' Office — Expenditure by Hospital — August 2007
		YTD
	Approved Allocation	Actual	Budget	Variance
	€000	€000	€000	€000	%
Waterford Regional Hospital	142,019	96,802	94,733	2,069	2.2
St Lukes Kilkenny	53,164	37,968	35,200	2,768	7.9
Wexford General Hospital	53,169	36,137	34,712	1,424	4.1
St Josephs Hospital	50,317	36,762	32,624	4,138	12.7
Our Lady’s Hospital Cashel	0	0	0	(0)	-184.4
Kilcreene Orthopaedic Hospital	6,063	4,818	3,990	829	20.8
South Eastern Acute Services	0	0	0	0	0.0
South Eastern Acute Support	612	2,873	408	2,465	604.3
Network Manager — South Eastern Hospitals	6,257	380	4,086	(3,706)	-90.7
South Eastern Hospitals Group	311,601	215,739	205,753	9,986
Cork University Hospital	258,749	177,869	172,073	5,796	3.4
Unified Maternity / Neonatal (Erinville)	0	0	0	0	0.0
St. Mary’s Orthopaedic Hospital	13,986	10,741	9,305	1,436	15.4
Mallow General Hospital	14,728	11,530	9,796	1,735	17.7
Kerry General Hospital	74,848	50,936	49,832	1,104	2.2
Bantry General Hospital	17,882	12,160	11,895	265	2.2
Mercy University Hospital, Cork	70,826	49,770	47,416	2,354	5.0
South Infirmary — Victoria Hospital, Cork	52,701	36,758	34,967	1,791	5.1
Southern Regional Acute Services	16,720	13,132	11,149	1,984	17.8
Southern Regional Acute Support	0	0	0	0	0.0
Network Manager — Southern Hospitals	4,722	2,036	3,109	(1,073)	-34.5
Southern Hospitals Group	525,161	364,933	349,541	15,391
Sligo General Hospital	103,754	80,850	69,425	11,424	16.5
Letterkenny General Hospital	98,670	71,705	65,949	5,756	8.7
Galway College University Hospital	210,488	151,536	139,648	11,888	8.5
Merlin Park Regional Hospital	45,749	31,574	30,313	1,260	4.2
Mayo General hospital	69,460	55,134	46,186	8,949	19.4
Roscommon General Hospital	21,297	16,551	14,043	2,508	17.9
Portincula Acute Hospital	45,341	33,913	29,626	4,287	14.5
Western Regional Acute Services	15,201	560	10,106	(9,546)	-94.5
Western Regional Acute Support	0	0	0	0	0.0
North Western Regional Acute Services	510	1,575	506	1,069	211.0
North Western Regional Acute Support	131	100	87	13	15.0
Network Manager — West / North Western Hospitals	12,338	236	8,163	(7,927)	-97.1
West / North Western Hospitals Group	622,940	443,735	414,054	29,681
St. John’s Limerick	22,121	15,493	14,511	982	6.8
Regional Hospital Dooradoyle	157,218	104,837	103,825	1,012	1.0
Regional Maternity Hospital Limerick	18,141	13,541	11,837	1,704	14.4
Regional Orthopaedic Hospital	13,397	8,722	8,860	(138)	-1.6
Ennis General Hospital	22,279	17,118	14,721	2,397	16.3
Nenagh General Hospital	20,494	15,765	13,459	2,306	17.1
Mid Western Regional Acute Services	1,596	1,518	1,059	459	43.3
Mid Western Regional Acute Support	0	0	0	0	0.0
Network Manager — Mid Western Hospitals	6,431	766	4,191	(3,425)	-81.7
Mid Western Hospitals Group	261,676	177,760	172,463	5,297
Our Lady’s of Lourdes Hospital	90,979	66,723	59,955	6,768	11.3
Louth County Hospital	28,686	20,960	19,080	1,879	9.9
Cavan Monaghan General Hospital	57,840	44,733	38,124	6,609	17.3
Monaghan General Hospital	22,203	16,389	14,647	1,741	11.9
Our Lady’s Hospital Navan	36,579	29,520	24,382	5,138	21.1
North Eastern Regional Services	15,287	1,442	9,460	(8,018)	-84.8
North Eastern Regional Support	0	0	0	0	0.0
Network Manager — North Eastern Hospitals	0	0	0	0	0.0
North Eastern Hospitals Group	251,575	179,766	165,648	14,118
Mater Misericordiae University Hospital	226,559	163,115	149,912	13,203	8.8
Beaumont Hospital	262,628	187,258	168,117	19,141	11.4
Rotunda Hospital	48,545	34,060	31,340	2,720	8.7
Children’s University Hospital, Temple Street	71,629	54,183	47,730	6,453	13.5
Cappagh National Orthopaedic Hospital	27,844	19,116	18,563	553	3.0
Connolly Memorial Hospital	94,612	69,150	63,660	5,491	8.6
Northern Area Regional Acute Services	18,221	1,345	12,141	(10,796)	-88.9
Northern Area Regional Acute Support	0	0	0	0	0.0
Network Manager — Dublin North East Hospitals	261	233	179	54	30.2
Dublin North Hospitals Group	750,299	528,460	491,641	36,819
Mullingar General Hospital	53,461	41,007	35,576	5,431	15.3
Tullamore General Hospital	79,136	57,906	52,703	5,203	9.9
Portlaoise General Hospital	40,741	33,036	27,058	5,978	22.1
Naas General Hospital	61,626	40,985	41,187	(202)	-0.5
Midland Regional Acute Service	4,593	3,454	3,679	(225)	-6.1
Adelaide & Meath Hospital Tallaght	205,102	156,085	135,787	20,298	14.9
Coombe Womens Hospital	48,177	34,372	29,131	5,241	18.0
Our Lady’s Hospital for Sick Children Crumlin	125,738	91,816	85,737	6,079	7.1
Midland Regional Acute Support	0	0	0	0	0.0
South Western Regional Acute Service	0	0	0	0	0.0
South Western Regional Acute Support	1	0	0	(0)	-100.0
Network Manager — Dublin Midlands Hospitals	12,588	221	8,218	(7,997)	-97.3
Dublin / Midlands Hospitals Group	631,163	458,883	419,078	39,805
St. Vincent’s Elm Park	214,432	151,704	142,956	8,748	6.1
St. Michael’s Dun Laoghaire	32,349	22,285	21,750	535	2.5
National Maternity Hospital Holles Street.	47,718	32,113	31,808	305	1.0
City of Dublin Skin & Cancer Hospital	160	0	0	0	0.0
St. Lukes Hospital	35,992	24,754	23,024	1,730	7.5
Royal Victoria Eye & Ear Hospital	23,846	16,400	15,553	847	5.4
St. James’s Hospital	351,901	243,262	230,478	12,784	5.5
St. Columcilles General Hospital	37,364	29,847	25,035	4,812	19.2
East Coast Regional Acute Service	0	0	0	0	0.0
East Coast Regional Acute Support	0	0	0	0	0.0
Network Managers — Dublin South Hospitals	32,509	7,286	21,061	(13,775)	-65.4
Dublin South Hospitals Group	776,271	527,650	511,665	15,985
South Eastern Regional Ambulance Service	15,993	13,040	10,612	2,428	22.9
Southern Regional Ambulance Services	15,613	12,028	10,472	1,556	14.9
Western Regional Ambulance Services	14,435	12,599	9,595	3,004	31.3
North Western Regional Ambulance Service	11,046	8,900	7,302	1,598	21.9
Mid Western Regional Ambulance Service	10,952	7,815	7,223	591	8.2
North Eastern Regional Ambulance Service	10,680	8,290	7,121	1,169	16.4
Northern Area Regional Ambulance Service	0	0	0	0	0.0
Midland Regional Ambulance Service	19,906	6,668	10,549	(3,881)	-36.8
South Western Regional Ambulance Service	0	0	0	0	0.0
East Coast Regional Ambulance Service	30,755	22,739	20,595	2,144	10.4
Regional Ambulance Services	129,381	92,079	83,468	8,611
Office of the National Director	31,824	7,115	21,126	(14,011)	-66.3
National Hospitals Office Total	4,291,890	2,996,121	2,834,438	161,683

Question No. 141 answered with QuestionNo. 139.

Question No. 142 answered with QuestionNo. 104.

Question No. 143 answered with QuestionNo. 118.