UP TO 900 beds in community nursing homes face closure next year due to budget cuts in plans drawn up by the Health Service Executive.
In its draft service plan to be given to Minister for Health James Reilly next week, the HSE says 10 publicly run community nursing units could be shut down.
Overall the plan says cost reductions of €563 million must be made across the health service next year. It says staffing reductions of 3,200 are required in 2012 under Government employment policies but, based on the financial allocation to the HSE for 2012, “it may be necessary to reduce employment levels by up to 4,500”.
The report says the impact of the budget cuts will be felt more directly on frontline services in 2012 than in previous years.
The service plan is the legal agreement between the HSE and the Government on how its €13 billion budget will be spent next year. It has to be sent to the Minister by December 28th and, under legislation, he has 21 days to consider it.
It was drawn up by senior HSE management but has been the subject of a number of meetings with senior Department of Health personnel in recent weeks. The Minister briefed the Cabinet on the outline of the draft plan last Tuesday.
According to sources, some Government figures were shocked at the scale of the cuts envisaged.
The Minister for Health has to date accepted the substance of the HSE service plan, but cuts on this scale have not been put forward by the executive previously.
The cuts set out in its draft plan for next year extend across the health service.
Under the proposals, hospitals face reductions of 3 per cent in their budgets compared to their official allocations for last year. However, the plan says in reality the cost reductions will be about 7 per cent when account is taken of financial deficits brought forward into 2012. The draft plan suggests activity levels in hospitals may fall by 5 per cent next year.
The budget for primary care/community demand-led services is set to fall by €51 million under the proposals. However, a new target to save €124 million on drug costs will be put in place.
The plan also proposes a 5.5 per cent cut in home-help hours provided but says this will be compensated “by a more rigorous approach to the allocation of these supports”.
In the mental health area it warns of “closure of core service elements such as acute in-patient beds, acute community services and high-dependency continuing care”. It says there will also be cuts in payments to external agencies “who will be challenged to maximise efficiencies”.
As a result of budgetary restrictions for child and family services, there will be “reductions in the level of some community-based services which are more universal and less targeted”, the document says. “Based on the 2012 costs, the impact of the 2012 budget will require a 7 per cent reduction in expenditure in 2012 despite a 4 per cent increase in real terms.”
Cutbacks this year in services for older people have already led to protests over the closure of community nursing facilities but the draft plan says these cuts will intensify next year.
“It is anticipated that a minimum of 555 public beds will be closed [in community nursing units] in the course of the year if the anticipated reduction in staff numbers materialises.
“Most of these will be as a result of bed closures rather than whole unit closures but it is anticipated that a small number of units will be considered for total closure in 2012.”
The plan also says some beds may have to close because they will not be able to meet national standards in relation to physical infrastructure in homes.