James Reilly (Dublin North, Fine Gael)

The figure of €320 million to which the Deputy refers is the overall projected overrun in the HSE Vote. The latest Vote data have reduced this forecast to €300 million. The HSE was required to make gross savings of €962 million in its national service plan this year. The plan which was approved in December 2010 requires the HSE to operate within the limits of its Voted allocation and has been framed to deliver service levels in 2011 broadly in line with 2010 levels, while reducing the cost of providing services.

In the acute hospital sector a significant variation in productivity between hospitals was identified, particularly in day case rates, same day admissions and length of stay. All hospitals have been advised that they must operate within their allocated budgets and meet the service level activity targets they agreed for 2011. It has been made clear that those hospitals which fail will face consequences.

Despite the fact that the hospital sector has managed to deliver some reductions in its cost base during the first nine months of the year, at the end of September there was an accumulated deficit of €145.6 million in hospitals. While some hospitals are on target to break even, having managed the reductions in their budgets, the deficit in the hospital sector grew again in September by €3 million. Although the rate of growth has slowed, demonstrating that the sector is now operating within a much more sustainable level of expenditure, there is still a significant deficit which falls to be addressed. The HSE is implementing measures to address its overall deficit, including measures to ensure that hospital activity levels, which are running over target in many cases, are brought back in line with the national service plan targets, and accelerating the collection of outstanding income due in respect of the treatment of private patients. I am on record as saying that every individual agency has responsibility for managing its budget and must take all necessary measures to stay within budget while delivering its planned level of service. Under its reform programme the Government has committed to achieving greater efficiency in patient care and service delivery. These efficiencies will not be easy to achieve but I am certain that over time they will help to ensure that more people get access to services within the resources available.

As the Deputy is aware, I established the special delivery unit earlier this year with the objective of addressing the obstacles that prevent patients being seen and treated quickly. In order to address the problems in emergency units, to date €2.3 million has been committed to 15 hospitals which represent 80% of trolley waits. Funding is approved on the strict understanding that it will be released only where the specific performance measures and specified conditions have been met, including the requirement that no patient will wait more than 23 hours in an emergency department.

In respect of the broader financial issues in the hospital sector, the HSE continues to work closely with all hospitals to ensure the service impact of cost containment is kept to a minimum and to ensure patient safety remains at the core of all decision making.

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