Health spending fell more in Ireland than in any other European country between 2008 and 2011, with cuts of more than €2.7 billion and 12,000 fewer HSE staff, according to new research.
The Trinity College report on health spending and performance says that the health system managed to do more with less until 2012. But now there are “diminishing returns from crude cuts,” which means “the system has had no choice but to do less with less,” according to health expert Dr Sara Burke, who is one of the report’s authors.
Spending reductions were achieved through significant cuts to staff and pay, reducing professionals’ fees, better deals with pharmaceutical companies and more flexible working arrangements facilitated by the Croke Park agreement. But since November 2012, the number or people waiting six and 12 months for treatment has trebled.
The research, carried out by Trinity College’s Resilience Project into the impact of the economic crisis, also found that some of the savings were achieved by transferring the cost of care onto service users through increased charges for prescriptions and hospital services. It said this hit the oldest and sickest most.
Despite improvements in health service management, Dr Burke questioned the system’s ability to implement the current reform programme. “The change process, in terms of hospital groups and divisional directorates, is biting on the ground but with confusion, uncertainty and a lack of clarity, timeliness and communication. This is inhibiting the pace of change, the confidence managers feel about it, and their ability to bring others along,” she said.
She said differences between the departments of Health and Public Expenditure and Reform may put the sustainability of the public health system in jeopardy if more money is taken out of health in the year ahead.