A DUBLIN hospital facing a shortfall of more than €17 million this year has told the Health Service Executive (HSE) it can no longer accept patients referred to it from outside its catchment area if they are coming from regions that already have “appropriate” services.
St Vincent’s hospital, which has taken the step in a bid to cut costs, has indicated this will affect a wide range of patients, including those requiring pain management and cystic fibrosis sufferers.
It has indicated to the HSE that up to 30 per cent of its workload comes from outside its catchment area at an annual cost of about €10 million. While the hospital is the national adult referral centre for cystic fibrosis patients and about 25 per cent of its referrals for cystic fibrosis come from outside its catchment area, it said some of these were of “low acuity” and could be treated in their own areas.
It is considering “suspending” from its waiting list patients from outside its catchment area who are awaiting spinal cord stimulators, implanted for the management of pain. They cost €33,000 per patient. It is also looking at putting a cap on the number of patients undergoing these procedures in any month.
It acknowledged this would lead to waiting lists in excess of two years unless the HSE provided funding to “follow such patients”.
It said in one letter to the HSE that the National Treatment Purchase Fund “offers little opportunity to address these patients”.
The information on the hospital’s cost-cutting plans are contained in documentation released to The Irish Times under the Freedom of Information Act.
Its “break-even plan 2009” shows the hospital aims to reduce spending on implants and medicines by €2 million this year, reduce the volume of diagnostic tests carried out, reduce expenditure on private nursing home beds contracted in an effort to alleviate the problem of delayed discharges and it plans to cut by €1 million the amount it pays the Beacon private hospital for dialysis.
It has told the HSE that unless it provides funding for these services it will no longer be able to fund them from its own resources.
It also hopes to save €7 million on pay by cutting the amount it spends on temporary and locum staff, on premium pay and on on-call allowances. The documentation shows it faces a shortfall of €17.5 million this year unless action is taken now.
It stress to the HSE its breakeven plan outlined “targets only” which would only be met if there was “substantial flexibility from unions and staff”.
A spokesman for the hospital said yesterday some HSE hospitals which did not have sufficient resources were referring patients onwards to St Vincent’s in the hope that it would solve their “budgetary issues”. St Vincent’s was saying this had to stop, and it could not continue to provide services for the HSE without receiving the funding to do so.