Minister for Health Leo Varadkar has said a controversial menu of health cuts submitted to the Department of Public Expenditure and Reform represented "a paper exercise" to show the effects of a 5 per cent budget reduction.

He said he did not expect that the cuts set out in the document would happen. Taoiseach Enda Kenny said the confidential Department of Health paper, revealed in The Irish Times yesterday, set out a number of options and the Government had yet to take any decisions on the budget for next year.

In its submission to the Government’s comprehensive review of expenditure, the Department of Health warned it could not operate the public health system safely if further budget cuts were imposed.

It said any cuts to its expenditure ceiling or the introduction of a further 5 per cent budget cut would led to “draconian measures” that would compromise patient safety.

The submission said that among the measures that would have to be introduced in the event of further budget cuts were the closure of nearly 300 hospital beds and the cancellation of 2,400 high-tech procedures.

It maintained that a full 5 per cent funding cut would necessitate restricting opening hours in five emergency departments around the country.

It said charges for attending emergency departments would be increased to €125, and new levies for people attending outpatient clinics or availing of diagnostic services in hospitals would have to introduced.

Funding deficit

The department said rather than reducing spending further, the health budget needed an increase of €500 million next year to address the underlying funding deficit in its base.

It said an additional €200 million would also be required over each of the next three years to meet the demands of an ageing population.

Speaking at the conclusion of the Fine Gael parliamentary party think-in, the Taoiseach said: "The Minister for Public Expenditure wrote to every Minister and said, 'I need to respond now to the ceilings that have been set for your department and the ceilings you have been allocated, therefore I need to see all of the options that are set out in meeting the challenges to reach that target.'

“The Department of Health in preparing its report has set out all of those options. There have been no decisions taken about the budget yet.”

Mr Kenny said a supplement estimate “of very significant proportions” would be required for the department this year and that discussions would take place between the Minister for Health and the Minister for Public Expenditure.

“The response from the Department of Health sets out all of the options that might be considered in order to meet their targets. We want the health services to function.”

The Irish Medical Organisation maintained that health services would not be able to cope with patient demand if sufficient funds were not made available for the health services.

Crisis of confidence

Its president Prof

Trevor Duffy

said the outlook for the health services was increasingly bleak and that intergovernmental disputes were contributing to a growing crisis of confidence both for patients and doctors.

“Our public health services have been starved of adequate funding at a time when there is increasing demands and an ageing population.

“We have been warning for many years that the situation is simply not sustainable.”