Tuesday 12 December 2017

How exactly will surgery cutbacks at our hospital save money?

Ger Walsh

Last week's announcement by the management of Wexford General Hospital that certain types of surgery are to be cut back to enable the hospital get its budget under control is understandably frustrating and annoying for the general public, and quite frankly, it seems a bizarre way of dealing with a financial problem.

The first thing to be acknowledged is that the hospital insists no urgent surgery will be postponed and we take them at their word, but that still will not stop people worrying about their ability to get treatment if they need it.

What puzzles me, and something which I think should be explained to the public, is how this cutting back on surgery, and let's be honest, all surgery is urgent to the person waiting to undergo it, is going to save money.

Under the Croke Park Agreement, no nurses, doctors, consultants, ward assistants, administrators or managers can have their working hours or rate of pay reduced as a result of the reduction in activity in the hospital.

What will a cut in the number of surgeries achieve if payroll is not affected? I suppose some electricity could be saved as a result of not having the lights on in the Operating Theatre when the postponed operations would have taken place, and maybe some disposable gloves and other hygiene materials may be saved, but this would hardly amount to the difference between financial ruin and staying within budget.

The public deserves a transparent explanation of how money has been spent at the hospital and exactly how postponing surgery will save the required cash. The county's public representatives would do well to put pressure on the HSE to have these details published, so that people can see clearly where money is being spent and saved.

In any private business, a reduction in core activities - and after all you can't really get much more core activity in a hospital than surgery - would automatically result in a cut in staff at all levels, from management through administration, to the people directly involved in the postponed activity. But that will not happen at Wexford General Hospital (or indeed at any other hospital) so people have great difficulty understanding how the proposed action will achieve the required savings. The only thing which is certain is that patients will be adversely affected by the decision.

In a way, isn't this proposal a bit like a supermarket having hired additional staff to cope with peak summer trade announcing in October that that two aisles will close until the end of the year to save money on electricity, or a newspaper preparing a full edition but deciding not to print it to keep costs within budget, or a butcher not operating the slicing machines on Saturdays with the result that no rashers or lamb chops would be sold on that day?

No doubt the HSE and the Department of Health will dismiss these comparisons as ludicrous. However, they are no more ludicrous than a hospital not being able to carry out core functions while all the highly paid executives of the HSE and everyone else in the system retain their salaries, increments and special allowances.

The public deserves an answer on this and the county's public representatives really have a responsibility to ensure that the full details are provided.

Otherwise it is difficult to get away from the growing perception that patients are being denied care at a time when many within the health service are enjoying the same salaries and benefits for delivering less.

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