Written answers
Wednesday, 17 October 2007
Department of Health and Children
Hospital Services
9:00 pm
Chris Andrews (Dublin South East, Fianna Fail)
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Question 138: To ask 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]
Mary Harney (Dublin Mid West, Progressive Democrats)
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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 (Kerry North, Sinn Fein)
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Question 139: To ask 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 (Dublin South Central, Sinn Fein)
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Question 141: To ask 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]
Mary Harney (Dublin Mid West, Progressive Democrats)
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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 (Sligo-North Leitrim, Fine Gael)
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Question 140: To ask 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]
Mary Harney (Dublin Mid West, Progressive Democrats)
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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 |
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