A WINTER of discontent is being forecast for the health services in Limerick as unions this Wednesday prepared for a briefing from HSE management on how the latest round of cutbacks is to affect staffing levels and patient care.
As it attempts to rein in a €15 million deficit at the Mid-Western Regional Hospital - the largest faced by any hospital in the country - the HSE this week announced it is to close 25 beds in Dooradoyle.
This represents about five per cent of the bed complement at the Regional but unions are also concerned about the effect on patient care of HSE plans to reduce agency and overtime costs across the Mid-West by 50 per cent from next week.
Agency workers have been brought in to cover for staff who are out sick and to fill gaps while the staffing moratorium remains in place. But the HSE Mid-West this week said it could “no longer finance the cost of agency and overtime as a means of replacing staff in a moratorium-controlled environment”.
The Executive also this week rejected claims of nepotism from sources at St Camillus’ Hospital, who said that the children of management staff were being insulated from the cutbacks in agency staff to date.
Last year, the HSE spent €26 million on agency and overtime out of a total pay bill of €386 million. A proposal being examined in May to cut the agency and overtime bill by 33 per cent would have saved almost €4 million but the fresh proposal goes further in aiming to halve these costs.
The overall budget allocation to run health and social services in the Mid-West this year stands at €610 million, a reduction of around €40 million on what was spent last year.
SIPTU and the INMO were both due to meet management this Wednesday on the latest cost-containment proposals and what services are to be affected by the bed closures.
Jim McGrath, SIPTU nursing representative, said the union’s “consistent position has been that it would be more cost-effective to take on newly-qualified nurses rather than agency staff”. He now fears patients will bear the brunt of the cuts in the agency staffand overtime bill.
“We are seriously concerned for patient safety and that these cutbacks in beds and staffing will exacerbate the serious overcrowding we already have both on the wards and in A&E at the Regional Hospital.” Claims that there had been already been widespread cancellations of elective surgery this week are understood to be wide of the mark.
Three operations in Dooradoyle were cancelled on Tuesday but this was just a small fraction of the work planned. But sources this week predicted a “very rough winter” ahead as the winter vomiting bug and other seasonal ailments begin to kick in towards the end of the year. Cutbacks in elective surgery are expected although HSE area manager Bernard Gloster told the Limerick Leader earlier this summer that procedures under the National Cancer Control programme, which are considered elective, will be protected.
The HSE said this week: “At the end of June, the services in the Mid-Westwere €21 million in excess of the available budget and there are no options outside the Mid-West to source this money. There is a clear expectation that the services will manage within available budget”.
As well as reducing the agency and overtime bill, the HSE will “continue to focus on reducing absenteeism, maximising opportunities to change rosters and redeploying staff, and all other means by which we can provide the highestpossible level of service”. The Executive was working with its front-line managers to “minimise the impact on front-line service delivery”.
Meanwhile, the HSE has defended managers against claims that cutbacks in agency staff are not being implemented in an even-handed way. According to sources in St Camillus’ there had been up to 20 agency staff working at the hospital for the elderly until a number of weeks ago. These had all now been let go apart from three people who are the children of management staff, they said.
“It’s one rule for the management and another rule for everybody else,” a source said this week.
The HSE responded that while the staff in question had been working shifts in St Camillus’ Hospital this week, they were far from the only agency workers so doing.