The Irish Medical Organisation is appealing to the Government to seriously consider the long-term effects of further budget cuts on the health of the nation and the health system.

With further planned cuts of €1bn, moratorium on staff and the loss of up to 5,000 support and clerical staff through redundancies and early retirement, the IMO are calling on the Government to consider recommendations outlined in their Budget Submission, reverse the decision to charge 50 cent per prescription item under the GMS and Long Term Illness schemes and implement the IMO’s proposal to reduce the State’s drug bill by €300m through a coherent generic medicines policy and double the Carers allowance.

IMO President, Prof. Sean Tierney said; “The recommendations outlined go some way to alleviate the immediate impact on front line services and the health of the nation. It also outlines possible fund raising projects and long term cost saving measures.”

He said; “The recession is impacting on health and healthcare. As incomes decline people eat cheaper and less healthy meals, drop sports activities, delay visiting their GP and are less likely to afford preventative care. Chronic diseases and the underlying lifestyle factors that contribute to them are higher among lower income groups. Research shows that 38% of those at risk of poverty and 47% of those living in consistent poverty report having a chronic illness compared to 23% of the general population.”

The medical profession also stated that the recession is having a profound effect on mental health and mental health services.
Prof. Tierney said; “Mental health problems are estimated to cost the economy over €3bn (in terms of lost output, healthcare and other costs) yet in 2010 just 5.2% of the health budget was allocated to Mental Health Services, down from 7% in 2008. Due to the moratorium on recruitment over 700 staff have left the Mental Health Services, of which just 65 were replaced, compromising quality of care.”

He said; “Suicide rates in 2009 increased by 24% with incidents of self-harm increasing by 5% with higher rates among young males, yet the budget for mental health services has fallen disproportionately.”

The IMO are also calling on the Government to double the carer’s allowance and increase the provision of respite services. Prof. Tierney said; “There are an estimated 161,000 carers who save the exchequer approximately €2.5 billion a year. Because of their social and economic circumstances carers are at an increased risk of mental health problems. Adequate support and respite must be provided to enable them to care for someone as long as they wish and can, without jeopardising their own health and well-being.”

“An investment approach is needed and funding should be ring-fenced for the promotion of healthy lifestyles the prevention of chronic disease and mental health.” IMO Initiatives include:

• Increase the price of a packet of 20 cigarettes by €2
• Levies on tobacco and alcohol should be ear marked for health initiatives
• Introduce a sliding scale of alcohol taxes with the lowest tax on low alcohol beer and the highest tax on spirits
• Guarantee funding for evidence-based preventative care and screening
• Provide resources for the expansion of chronic disease management and prevention in primary care
• Increase and ring-fence funding for Mental Health Services in line with the recommendations of A Vision For Change
• ncrease funding for suicide prevention and mental health awareness
• Double the carer’s allowance and increase the provision of respite services

“With more patients being admitted to hospital (approx 10% more than planned) and hospital budgets overrun, our Acute Hospital System is under severe stress and struggling to meet the growing healthcare needs of the public,” said Prof Tierney,

The HSE is persevering with reform without the necessary Capital funding and with a budget reduced by €1 billion. The HSE’s Preferred Health System (PA Review on Acute Bed Capacity) suggests that with a better balance between inpatient, day case and community-based care just 8,008 public hospital beds will be required in 2014 compared to 11,660 in 2007.

However, the Preferred Health System relies on the progress of the following strategies:

• An additional 1,000 private beds to be supplied through the co-location project and continued demand for private health care
• The Hospital Transformation Programme and the reconfiguration of major hospitals into regional centres of excellence accompanied by the downgrading of smaller local hospitals;
• Implementation of the Primary Care Strategy [2001] including the creation of more than 500 Primary Care Centres;
   

Progress on these to date:

• Not one hospital bed has been provided to date through the co-location project, despite generous tax incentives.
• The first private hospital may not be completed until 2013 – despite planning permission given to four hospitals
• Over 40,000 people have cancelled private health insurance between June ‘09-June 2010 and this is expected to rise.
• In September 2010 the HSE publicly announced that the Hospital Transformation Programme needs increased revenue spend as well as capital investment
• HSE identified 530 Primary Care Teams [PCTs] & 134 Health & Social Care Networks to be developed by 2011. In August 2010 just 284 [PCTs] are holding clinical meetings – many of these are “virtual” teams. The actual number of physical PCTs is unclear as is the number of Social Care Networks
   

Recommendations outlined by IMO:

• Discontinue the Hospital Transformation Programme and the closure of hospital beds until adequate alternative services are in place;
• Provide tax incentives for the development of Primary Care Centres;
• Withdraw tax incentives for private hospitals and replace the Co-Location project with funding for units for elective patients and patients with chronic illness, and
• Value for money must be sought in state capital projects