David Cullinane (Sinn Fein)
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I welcome the Minister of State to the House to respond to this important issue for people in Waterford and the south east, namely, the impact of health funding cuts on acute hospital services in Waterford and for patients throughout the south east.

As I understand it, there is to be a cut of approximately €6.5 million this year in the budget of Waterford Regional Hospital, which is to be recouped by way of cuts in services across all departments. The Minister has been very defensive about all this. However, there will be cuts to services across hospitals in particular acute services owing to health cutbacks.

Information given to me by people who work at Waterford Regional Hospital indicates that the cuts to be imposed this year will be severe and will impact on patient care. Some of the cuts under consideration are a 5% reduction in inpatient activity; a 10% reduction in the number of day cases; a 20% reduction in the number of new patients in the outpatient department; the closure of theatres and a surgical ward; the loss of paediatric inpatient beds, as well as beds in other units; and reduced expenditure on medication for the regional rheumatology day-service unit, for which a reduction of 50% will mean restricted access to treatment for patients with severe arthritic conditions. It is obvious that there will be dramatic cuts across all services at the hospital.

When I released the information to which I refer, one of the Minister of State's party colleagues accused me of misleading the public and acting reprehensibly. I must inform Fine Gael, the Minister of State and the Government that what is reprehensible is cutting funding to hospitals and allowing a situation to develop where front-line services will be either curtailed or lost. In opposition, the Minister of State's party made great play of the fact that, if elected to govern, it would deal with the real waste in the system, namely, bureaucracy and in the various management layers in the HSE, hospitals and the Department. What we have been presented with, however, is a one-size-fits-all approach to cuts in services, etc., in all hospitals. That is a far cry from the money following the patient approach - whatever that meant in the first instance - to which the Minister for Health, Deputy James Reilly, referred when in opposition. In many ways, that approach is penalising efficiency.

I was present at a meeting attended by members of the Minister of State's party and clinical directors and leading clinicians at Waterford Regional Hospital. Those who work in the hospital pleaded with us to appeal to the Minister for Health to have the cuts reversed. They also impressed upon us the need to ensure there would be proper acute services in the region. I accept that there is also a need for a reorientation of services across the region. Waterford Regional Hospital must function as the region's acute hospital. In addition, it must specialise in the provision of complex acute services in areas such as cancer care, neurology, cardiology, etc. As a result of cuts to its funding, however, it is not being given the opportunity to provide such services. There are real concerns about the retention of some of the services to which I refer.

I am seeking clarity. People have referred to the spreading of misinformation on this matter. The HSE should publish its plans for the hospital. Deputies in the Lower House should not act as public relations officers for the HSE. As public representatives, it is our responsibility to ensure we defend hospital services. All I am interested in is obtaining the facts from the HSE and discovering what the impact of the cuts in funding will be on patient care at the hospital in the area in which I live. There is a need for honesty in this matter and clarity with regard to the cuts to be implemented at the hospital.

Is the Minister of State in a position to confirm that there is going to be a cut of €6.5 million to the budget of Waterford Regional Hospital? Will he indicate whether there will be cuts across the various departments? People should be told the truth. In the context of the HSE's national service plan, the Minister for Health has acknowledged that there will be cuts to services. However, local politicians throughout the country are stating there will not be any cuts at the hospitals in their areas. There are going to be cuts to services as a result of the overall reduction in funding. People should be honest about that fact.

Ciarán Cannon (Galway East, Fine Gael)
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I am taking this matter on behalf of my colleague, the Minister for Health, Deputy James Reilly.

The health sector is facing significant funding challenges this year. As a result of the current crisis, the absolute priority must be to place the economy and the public finances on a sustainable footing. However, the Minister is determined to ensure the impact on services is minimised through relentless performance management, best practice and reform in how services are delivered. This will apply in all settings and services and for those delivering such services.

The HSE's national service plan 2012 was approved by the Minister on 13 January and published by the HSE on 16 January. It sets out the health and personal social services that will be delivered by the HSE within its current budget of €13.317 billion and identifies a cost-reduction target in 2012 of €750 million. It reflects the commitments in the programme for Government in respect of health and the savings targets set out in the comprehensive expenditure report for the period 2012 to 2014.

The scale of the financial challenge facing the HSE means that there will be an inevitable and unavoidable reduction in services. However, this will not be a straight line reduction. Waterford Regional Hospital, in line with other acute hospitals, must face the challenge of reduced budgets and align its 2012 activity levels and services to the budget allocated. As a direct result of budgetary and staff reductions nationally, activity levels in 2012 will be expected to fall by approximately 6%. The Minister hopes this can be contained to 3% through increased efficiency, including the effective implementation of the clinical programmes. In this regard, at Waterford Regional Hospital strategic integration is taking place of the acute medicine programme into hospital processes, with further realignment of beds with this model, including those in the medical assessment and acute medical admissions units. Furthermore, the number of short-stay beds and rapid access outpatient clinics is increasing in order to improve admission avoidance. In addition, the productive theatre initiative was introduced in December 2011 and work is advancing at pace in order to maximise patient access. Surgical bed stock realignment will begin in early 2012 to underpin and retain the performance to date in day-case surgery. The hospital is performing consistently well, including in the context of delivering on special delivery unit targets for scheduled and unscheduled care, in the emergency medicine programme. The Minister is satisfied that elective activity targets, while challenging, will be enabled by the successful implementation of the elective surgery programme and the positive theatre initiative.

The HSE's national service plan commits it to minimising the impact on services by fast-tracking new, innovative and more efficient ways of using limited resources. It reflects the need to move to new models of care across all service areas in order to treat patients at the lowest level of complexity and provide quality services at the lowest possible cost. It also includes a commitment to addressing staffing levels, skill mix and staff attendance patterns-rosters within the framework of the public service agreement. The plan will be implemented in the context of the significant new governance structures for the health service recently announced by the Minister.

The HSE is satisfied that Waterford Regional Hospital will deliver on its 2012 service plan without any impact on emergency or urgent care services. The details of the plan are being worked through. The final version of the plan will be available on publication of the regional service plan for HSE South on 9 February.

David Cullinane (Sinn Fein)
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I am sure the Minister of State's speech was written by a civil servant. The information it contains was obviously obtained by the HSE. On each occasion we ask questions about what is going to happen at Waterford Regional Hospital, all we get from the HSE is spin. We are informed about new appointments which might happen at some point in the future. However, we are not being given details in respect of how the €6.5 million cut in the hospital's funding will impact on patient care. The Minister of State has indicated that activity levels are expected to fall by 6%. I presume this is an across-the-board figure for the health service nationally. It is possible that the figure might be above 6% for certain hospitals. As stated, the information given to me by people who work in Waterford Regional Hospital indicates that, in some instances, the figure will certainly be higher than 6%.

I look forward to publication of the regional service plan for HSE South in next week. When it emerges, we will see the real detail with regard to what is envisaged. Unfortunately, many of the plans published by the HSE do not contain such detail and all we tend to get are vague commitments about things that may occur in the future. Information on what is happening in individual hospitals tends to be absent from such plans.

Many of the staff at Waterford Regional Hospital, including consultants, clinical directors, clinicians and front-line staff, are extremely concerned about the impact of the proposed cuts on service delivery. I do not know whether the Minister for Health wants to accept this, but it is the reality for those who work in the hospital.

Ciarán Cannon (Galway East, Fine Gael)
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I have the utmost respect for every Member of both Houses of the Oireachtas and 99.99% of us are here to try to create a better country for the people whom we serve; it is an incredible honour and privilege to sit in either House. This includes Senator Cullinane, as my respect extends to everybody who operates in this environment. However, in recent weeks my respect for Sinn Féin has begun to dwindle.

We are operating in an incredibly difficult economic environment. This is a fact and Senator Cullinane must admit this as must I. In Northern Ireland, 100 miles up the road, there is an equally difficult - some might argue an even more difficult - economic environment because of the cuts handed down to the Northern Ireland Government by the UK Government based in London. This has required Sinn Féin in government in Northern Ireland to make very difficult decisions, which it is willing to stand over, 100 miles away.

According to research I carried out earlier today the Northern Ireland Government proposes to cut €2.3 billion from its health budget next year. This will probably require redundancies in the order of 4,000 posts, including some enforced redundancies. This action prompted 26,000 health care workers to go on a one-day strike in Northern Ireland last September. If Sinn Féin is willing to acknowledge, and be honest in facing up to, these challenges 100 miles away - and they are definitely difficult economic challenges - why can it not be equally honest in this environment?

David Cullinane (Sinn Fein)
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They are different states. I do not stand over the cuts in the North. As the Minister of State said-----

Ciarán Cannon (Galway East, Fine Gael)
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The Senator's party does. That is all I am saying.

David Cullinane (Sinn Fein)
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-----the cuts are because of the cuts in the block grant from the British Government as the Minister of State well knows.