Máire Hoctor (Tipperary North, Fianna Fail)

I am taking the matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. The Government is committed to the provision of a high level of quality health services throughout the country, including in the Cork region. The HSE is obliged to provide services in line with available funding. In turn, all its managers and agencies have a clear responsibility to operate within their designated budgets and achieve the service levels for 2008 as set out in the HSE's national service plan. These include service level targets for the acute hospital services nationally of over 2.7 million outpatient attendances, almost 600,000 in-patient discharges and over 580,000 day cases. HSE management at national, regional and local level reviews expenditure and activity levels on a weekly basis in order to ensure that hospitals are adhering to the service levels of activity for which they have been funded.

The HSE has advised that to ensure that they remain within their approved expenditure levels, all hospitals within the southern hospitals group have put together a budget break-even plan for 2008. These plans are based on a realistic assessment of achievable objectives for the hospitals within the group. The plans were formulated with a view to maintaining all existing essential and emergency services while minimising the overall impact on patient care. Hospitals within the southern hospitals group have identified a number of value for money and income generating initiatives that will realise some savings in 2008. These measures include a reduction in the use of agency cover, locum cover and overtime. Several areas of non-pay expenditure have also been targeted for reduction, most particularly staff travel and non-essential training.

Over the past three years, the HSE allocated significant funding to the Mercy University Hospital to enable it to cope with service pressures. In 2006, the budget allocation was €67.7 million, in 2007 it was €72.2 million, while this year €73.6 million was allocated to it. An analysis of the Mercy University Hospital expenditure by the HSE in the early months of this year indicated that the hospital would significantly exceed its budget allocation unless corrective action was taken. With this in mind, management at the Mercy University Hospital was required to readjust the hospital's expenditure levels. Accordingly, the hospital introduced a number of value for money and efficiency initiatives along the lines already mentioned. It has also promoted initiatives which support the concept of working better and smarter, such as pre-operative assessment clinics, same-day admission process and reducing the length of stay. However, as these steps would not in themselves have been sufficient to bring projected expenditure back in line with permitted levels, management at the hospital decided to close a 31-bed ward. St. Catherine's ward was closed on 3 May 2008 and will, I understand, remain closed for the remainder of 2008.

Management at Mercy University Hospital and the HSE continue to monitor carefully the impact of these initiatives on the hospital's overall budgetary position. The Minister has been assured by the HSE that every effort will be made to ensure the measures outlined will have a minimal effect on patient services. The HSE has indicated essential, elective and emergency services will not be affected and that planned hospital service activity levels at the Mercy University Hospital for 2008 will be met.

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