Pat Breen (Clare, Fine Gael)
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Question 21: To ask the Minister for Health and Children the position regarding the deficit in the Health Service Executive west; the action being taken to address this deficit; if she will give a commitment that cost savings measures in Health Service Executive west will not affect front-line patient services; and if she will make a statement on the matter. [34719/10]

Joe Carey (Clare, Fine Gael)
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Question 32: To ask the Minister for Health and Children the position regarding the scale of the budget deficit in health in the four Health Service Executive areas; if she will provide a breakdown of the deficit per hospital; and if she will make a statement on the matter. [34725/10]

Richard Bruton (Dublin North Central, Fine Gael)
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Question 58: To ask the Minister for Health and Children the position regarding the scale of the budget deficit in health in the four Health Service Executive areas; the action being taken to address the deficit; if this action will include bed or theatre closures; the location of these closures; and if she will make a statement on the matter. [34721/10]

Seán Sherlock (Cork East, Labour)
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Question 82: To ask the Minister for Health and Children the financial state of hospitals nationwide; the number that will overspend their allocated budgets; and if she will make a statement on the matter. [34693/10]

Mary Harney (Dublin Mid West, Independent)
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I propose to take Questions Nos. 21, 32, 58 and 82 together.

The Revised Estimates for 2010 allocated €14.6 billion for the HSE. In setting the Estimates, the Government took difficult but necessary decisions to secure the economy and stabilise the national finances. In its National Service Plan, the HSE committed to achieving greater efficiencies while maintaining services at 2009 levels. At the end of August the HSE is reporting a deficit of €108m in the hospital sector along with a €28m deficit in community services. The results for the individual regions at the end of August are being provided in tabular form to the House. These are interim figures which are still subject to validation. The HSE is also forecasting lower than expected expenditure in areas such as demand led schemes, H1N1 vaccination costs and some national programmes.

The actions being taken by the HSE in all regions are focused on

protecting front-line services and in particular emergency services;

maintaining the quality and safety of services; and

delivering to service plan targets.

The principal measures being employed involve:

reducing pay and non-pay costs;

controlling absenteeism;

redeployment of corporate / support staff to frontline roles;

implementing measures to ensure that hospital care is delivered as efficiently as possible;

improved bed utilisation and discharge planning; and

procurement initiatives.

The HSE is driving efficiency in the acute hospital system by increasing the proportion of surgery undertaken on a day basis, increasing the admission of inpatients on their day of surgery and reducing length of hospital stay consistent with patients' clinical needs. Overall, activity in the acute hospitals is ahead of the Service Plan targets and measures have to be taken to bring elective activity back to target levels where this is necessary to address the projected deficit. Steps are also being taken to expedite the collection of private patient income and targets have been set for hospitals in this regard. The receipt of this income will contribute to tackling the projected deficit.

Specifically in the HSE Western Region, the latest indications are that it has reduced its projected end year deficit from €130 million at the end of March to €49.5m at the end of August. In order to address the remaining excess, the HSE West needs to achieve further reductions of €10 - €12 million a month for the rest of the year. The HSE West and the trade unions have been in discussions in the Labour Relations Commission in relation to a framework document to address the budget deficit, whilst protecting jobs and services. This engagement is continuing at present.

Notwithstanding the difficult financial environment, the Government is determined to do everything possible to protect patient services, to respond to priority demographic and other needs and to support ongoing reform of the public health services within the resources available for health. To achieve this, staff at all levels will have to work together to deliver services in a more flexible way. Without that co-operation and flexibility, services to patients cannot be protected. It is not just for HSE management to protect services: there is a responsibility on everyone involved to deliver services within budget in new ways that will better serve patient needs in accordance with international practice.