As non-consultant hospital doctors return to the picket lines, Eithne Donnellan looks at a financial crisis facing hospitals and health boards
Health boards and hospitals across the State have been warned by the Department of Health to keep within their annual budgetary allocations.
They have also been told that any deficits they run up will be deducted from their budget for next year.
In addition the Minister for Health, Mr Martin, has made it clear he won't be providing additional money for hospitals this year.
The implications for the health service don't bear thinking about given that overspending by hospitals and health boards this year is currently running at around €100 million.
The Master of the National Maternity Hospital at Holles Street revealed yesterday that the hospital had been left €1 million short in its funding requirements for this year.
Dr Declan Keane said the hospital would have to consider curtailing its activities next year unless further funding was provided. "We are going to be reaching a crux very soon . . . Something has to give . . . It will certainly mean rationalisation of our services," he said.
He conceded this may mean turning expectant mothers away. "At the end of the day, in this litigious society, I don't believe maternity hospitals can tell people to keep coming to us when we have neither the staff, the infrastructure nor the funding to deal with them," he said.
However, a spokeswoman for the Eastern Regional Health Authority (ERHA) claimed the hospital's budget had increased by €3 million this year, and talks on further funding were ongoing.
Collectively, the five major Dublin hospitals, Beaumont, St James's, St Vincent's, Tallaght and the Mater, fear they could face a shortfall of €50 million at the end of this year.
Our Lady's Hospital for Sick Children in Crumlin, Dublin, also had a €3 million deficit at the end of June. It is at present looking at ways "to curtail costs" without affecting patient care.
All these hospitals are in negotiations with the ERHA in an attempt to get additional funding. A spokeswoman for the authority emphasised that the ERHA had sufficient funds available this year to purchase health and personal social services at the same level as it had in 2001 and in addition to purchase service developments.
She also stressed that an additional 17,000 patients were treated in the acute general hospitals in the eastern region in the first five months of the year compared to the same period last year.
Health boards are also in a difficult position.
The Midland Health Board's director of finance, Mr Diarmuid Collins, said yesterday that the board had overspent by €2.1 million in the first six months of the year.
However, he said, it had no plans to cut services.
The North Eastern Health Board said its expenditure for the first six months of the year was €9.29 million over budget. "In a bid to bring expenditure back to budget levels a number of corrective measures have been put in place including the non-filling of 60 non-clinical posts," a spokeswoman said.
She added that the the implications of the overspending would be considered at next month's board meeting.
In the South Eastern Health Board, expenditure exceeded budget by €6.02 million at the end of May. However, additional funding is anticipated, and when this is taken into account, the figure is reduced to €4.93 million.
The Southern Health Board's overrun at the end of June amounted to €11.23 million. It has since been notified of €2.5 million in additional funding and was asked to make savings by not filling 100 administration posts.
However, the board said it hadn't that many vacancies in administration and would have to generate savings from alternative sources.
At the end of May the Western Health Board's deficit had reached €13 million.
It temporarily closed wards and theatres during the holiday season in an attempt to improve its budgetary position.
The North Western Health Board had overspent by €4.6 million at the end of June and the Mid Western Health Board by €100,000.
In addition the three area health boards in the Eastern region - the East Coast Area Health Board, the South Western Area Health Board and the Northern Area Health Board - had spent "marginally" over half their annual budgets at the end of June.
They hope to break even this year, and no service reductions are envisaged, a spokeswoman said.