Written answers

Wednesday, 17 October 2007

Department of Health and Children

Hospital Services

9:00 pm

Photo of Chris AndrewsChris 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]

Photo of Mary HarneyMary 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.

Photo of Martin FerrisMartin 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]

Photo of Aengus Ó SnodaighAengus 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]

Photo of Mary HarneyMary 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.

Photo of John PerryJohn 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]

Photo of Mary HarneyMary 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 AllocationActualBudgetVariance
€000€000€000€000%
Waterford Regional Hospital142,01996,80294,7332,0692.2
St Lukes Kilkenny53,16437,96835,2002,7687.9
Wexford General Hospital53,16936,13734,7121,4244.1
St Josephs Hospital50,31736,76232,6244,13812.7
Our Lady's Hospital Cashel000(0)-184.4
Kilcreene Orthopaedic Hospital6,0634,8183,99082920.8
South Eastern Acute Services00000.0
South Eastern Acute Support6122,8734082,465604.3
Network Manager — South Eastern Hospitals6,2573804,086(3,706)-90.7
South Eastern Hospitals Group311,601215,739205,7539,986
Cork University Hospital258,749177,869172,0735,7963.4
Unified Maternity / Neonatal (Erinville)00000.0
St. Mary's Orthopaedic Hospital13,98610,7419,3051,43615.4
Mallow General Hospital14,72811,5309,7961,73517.7
Kerry General Hospital74,84850,93649,8321,1042.2
Bantry General Hospital17,88212,16011,8952652.2
Mercy University Hospital, Cork70,82649,77047,4162,3545.0
South Infirmary — Victoria Hospital, Cork52,70136,75834,9671,7915.1
Southern Regional Acute Services16,72013,13211,1491,98417.8
Southern Regional Acute Support00000.0
Network Manager — Southern Hospitals4,7222,0363,109(1,073)-34.5
Southern Hospitals Group525,161364,933349,54115,391
Sligo General Hospital103,75480,85069,42511,42416.5
Letterkenny General Hospital98,67071,70565,9495,7568.7
Galway College University Hospital210,488151,536139,64811,8888.5
Merlin Park Regional Hospital45,74931,57430,3131,2604.2
Mayo General hospital69,46055,13446,1868,94919.4
Roscommon General Hospital21,29716,55114,0432,50817.9
Portincula Acute Hospital45,34133,91329,6264,28714.5
Western Regional Acute Services15,20156010,106(9,546)-94.5
Western Regional Acute Support00000.0
North Western Regional Acute Services5101,5755061,069211.0
North Western Regional Acute Support131100871315.0
Network Manager — West / North Western Hospitals12,3382368,163(7,927)-97.1
West / North Western Hospitals Group622,940443,735414,05429,681
St. John's Limerick22,12115,49314,5119826.8
Regional Hospital Dooradoyle157,218104,837103,8251,0121.0
Regional Maternity Hospital Limerick18,14113,54111,8371,70414.4
Regional Orthopaedic Hospital13,3978,7228,860(138)-1.6
Ennis General Hospital22,27917,11814,7212,39716.3
Nenagh General Hospital20,49415,76513,4592,30617.1
Mid Western Regional Acute Services1,5961,5181,05945943.3
Mid Western Regional Acute Support00000.0
Network Manager — Mid Western Hospitals6,4317664,191(3,425)-81.7
Mid Western Hospitals Group261,676177,760172,4635,297
Our Lady's of Lourdes Hospital90,97966,72359,9556,76811.3
Louth County Hospital28,68620,96019,0801,8799.9
Cavan Monaghan General Hospital57,84044,73338,1246,60917.3
Monaghan General Hospital22,20316,38914,6471,74111.9
Our Lady's Hospital Navan36,57929,52024,3825,13821.1
North Eastern Regional Services15,2871,4429,460(8,018)-84.8
North Eastern Regional Support00000.0
Network Manager — North Eastern Hospitals00000.0
North Eastern Hospitals Group251,575179,766165,64814,118
Mater Misericordiae University Hospital226,559163,115149,91213,2038.8
Beaumont Hospital262,628187,258168,11719,14111.4
Rotunda Hospital48,54534,06031,3402,7208.7
Children's University Hospital, Temple Street71,62954,18347,7306,45313.5
Cappagh National Orthopaedic Hospital27,84419,11618,5635533.0
Connolly Memorial Hospital94,61269,15063,6605,4918.6
Northern Area Regional Acute Services18,2211,34512,141(10,796)-88.9
Northern Area Regional Acute Support00000.0
Network Manager — Dublin North East Hospitals2612331795430.2
Dublin North Hospitals Group750,299528,460491,64136,819
Mullingar General Hospital53,46141,00735,5765,43115.3
Tullamore General Hospital79,13657,90652,7035,2039.9
Portlaoise General Hospital40,74133,03627,0585,97822.1
Naas General Hospital61,62640,98541,187(202)-0.5
Midland Regional Acute Service4,5933,4543,679(225)-6.1
Adelaide & Meath Hospital Tallaght205,102156,085135,78720,29814.9
Coombe Womens Hospital48,17734,37229,1315,24118.0
Our Lady's Hospital for Sick Children Crumlin125,73891,81685,7376,0797.1
Midland Regional Acute Support00000.0
South Western Regional Acute Service00000.0
South Western Regional Acute Support100(0)-100.0
Network Manager — Dublin Midlands Hospitals12,5882218,218(7,997)-97.3
Dublin / Midlands Hospitals Group631,163458,883419,07839,805
St. Vincent's Elm Park214,432151,704142,9568,7486.1
St. Michael's Dun Laoghaire32,34922,28521,7505352.5
National Maternity Hospital Holles Street.47,71832,11331,8083051.0
City of Dublin Skin & Cancer Hospital1600000.0
St. Lukes Hospital35,99224,75423,0241,7307.5
Royal Victoria Eye & Ear Hospital23,84616,40015,5538475.4
St. James's Hospital351,901243,262230,47812,7845.5
St. Columcilles General Hospital37,36429,84725,0354,81219.2
East Coast Regional Acute Service00000.0
East Coast Regional Acute Support00000.0
Network Managers — Dublin South Hospitals32,5097,28621,061(13,775)-65.4
Dublin South Hospitals Group776,271527,650511,66515,985
South Eastern Regional Ambulance Service15,99313,04010,6122,42822.9
Southern Regional Ambulance Services15,61312,02810,4721,55614.9
Western Regional Ambulance Services14,43512,5999,5953,00431.3
North Western Regional Ambulance Service11,0468,9007,3021,59821.9
Mid Western Regional Ambulance Service10,9527,8157,2235918.2
North Eastern Regional Ambulance Service10,6808,2907,1211,16916.4
Northern Area Regional Ambulance Service00000.0
Midland Regional Ambulance Service19,9066,66810,549(3,881)-36.8
South Western Regional Ambulance Service00000.0
East Coast Regional Ambulance Service30,75522,73920,5952,14410.4
Regional Ambulance Services129,38192,07983,4688,611
Office of the National Director31,8247,11521,126(14,011)-66.3
National Hospitals Office Total4,291,8902,996,1212,834,438161,683

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