The massive cut in the HSE allocation to the Dublin Hospitals is now hitting home with a vengeance.

The massive cut in the HSE allocation to the Dublin Hospitals is now hitting home with a vengeance.   It is important to remember that the Chief Executive of each hospital is legally responsible for balancing the budget.  My understanding of this is that he/she must take whatever steps appear necessary to keep within their allocation. Logically, this comes down to making hard choices.

The first objective should be to eliminate waste and duplication within the institution.  The second heading should be an examination of all cost bases to eliminate the least necessary.  The interface of the doctor and nurse with the patient must take priority in the business of a hospital. Therefore the administrative super-structure must be subjected to a lean study before ward closures or other reductions in patient services occur.

I very much doubt if such a study was carried out in any of our institutions.

I can assure the public that as Chairman of the Forum of the HSE for Dublin and the North East I will table a motion to parse the decisions of hospital administration across North Dublin, Drogheda, Cavan, Navan and Dundalk.

To illustrate just how serious the situation for the public in relation to hospital is becoming, the under shown memo from the Chief Executive from Beaumont Hospital, Mr. Liam Duffy to all staff does not need elaboration.


To: All Staff

From: Liam Duffy, Chief Executive

Subject: Developments in plans to meet budgetary constraints

Date: May 5th, 2010

Dear Colleagues

As you know, the Hospital is operating within severe financial constraints, with an allocated budget €19 million less than 2009. We continue to do our best to increase all revenue streams and improve bed utilisation while minimising the impact on staff and on service levels. These efforts are part of break-even plans prepared by the Senior Executive and the new Clinical Directorates and approved by the Hospital Board.

Increasing private bed utilisation – a move that will have no impact on patient services – is expected to yield €2 million. In addition, targeted reductions in prices from suppliers and other non-pay spending reductions are expected to yield a further €8.6 million.

However, this will still not be sufficient to achieve break-even and some measures will affect overall capacity and staff. Restrictions on overtime are being implemented and the use of agency staff has been reduced in the majority of departments. There will be non-replacement of retiring staff in a number of categories.

There will be reductions in designated beds for all specialities, with the exceptions of neurosurgery, transplantation and cancer services. However, reconfiguration of beds within a number of wards will be designed to minimise the impact of bed closures on patient services.

Jervis Ward, with 33 beds, will be closed by May 7th. Following this, Hamilton Ward will be closed by May 21st. Furthermore, there will be reconfiguration of beds in a number of wards so that the net effect of these closures on Hamilton will be a reduction overall of 19 beds. It is intended to close one theatre each week on a rolling basis to ensure that the impact of the move is shared mongst all surgical specialties. Staff members most directly affected by these measures have been informed.

Recently, the ten bed Admissions Lounge has been converted into an Acute Medical Unit. This accommodates referrals previously seen in the ED and should ease pressures there. Priority will still be given to a range of new developments designed to improve management of beds.

On that note, the Hospital is making good progress in implementing the new Nursing Home Subvention Scheme (the Fair Deal), which was introduced at the end of last year. The number of acute beds occupied by long-stay patients has been reduced from over 140 last November to 90 now. This means that at least 50 acute beds that had not been available for the treatment of new admissions have become available over this time, offsetting the reduction in beds now being announced. The number of long-stay patients will decline further in coming months with the opening of the new 100 bed unit for long-stay patients in St. Joseph’s.

The Hospital will continue to do everything within its power to enhance revenues and minimise the effects of the budgetary constraints.

Delivery of quality patient services remains our top priority.


Liam Duffy
Chief Executive