THE HEALTH Service Executive is planning to cut bed numbers, restrict some wards to five-day rather than seven-day operation and carry out more work on a day care basis next year.
The HSE's new service plan - the blueprint on how it will spend its €14 billion budget - also signals that it may consider the rationalisation of some emergency department services.
The HSE last night briefed trade union leaders on the service plan proposals which were submitted to Minister for Health Mary Harney for approval earlier this week.
In its briefing, the HSE indicated that it was proposing to reduce bed capacity in acute hospitals next year. However, it did not provide specific details on the number of beds that would be affected.
The HSE also indicated that it wanted to move towards increasing numbers of five-day wards in hospitals and to shift emphasis towards day surgery and procedures.
The plan would consider the rationalisation of emergency department services across hospitals and within hospital networks in line with service review recommendations and best practice for emergency service delivery.
It would also consider the functions of smaller emergency departments in local hospitals.
The plan states that this would be advanced in line with service reviews, activity analysis, including out-of-hours activity, and clinical directorate recommendations.
At the meeting with union leaders last night, the HSE also put forward a new framework document on work practice changes.
Health service management has been in talks with unions on work practice reforms for the last week or so. It is seeking to generate savings of up to €350 million next year as part of such a process.
The Irish Timesrevealed earlier this week that HSE management is seeking to reduce overtime across all grades by 50 per cent next year as part of these work practice reforms.
HSE management has also said that it wants to save more than €50 million by ending special grants, payments and allowances made to non-consultant hospital doctors.
It has also proposed introducing new centralised arrangements for contract procurement, which it maintained could secure about €25 million in savings.
In the framework document, issued last night, the HSE seeks agreement on how such reforms would be implemented at national and local level as well as on how delivery of the savings could be verified.
It is understood the unions did not accept the framework document and will bring forward their own proposals next week.
Informed sources said that the unions indicated that they would be pressing for high-level talks on policy issues with the Government as part of the current process.
The unions are to ask the Irish Congress of Trade Unions to set up a meeting with the Taoiseach's department on a number of issues such as funding for demand-led schemes in the HSE, greater access for public hospitals to the National Treatment Purchase Fund, the elimination of subsidies for private practice in public hospitals and eligibility issues.
