Minister for Health, James Reilly wrote to members of Fine Gael today. I thought you might be interested to see the contents. A winter of discontent ahead, how patients are not going to suffer when all agency staff are cut I don’t know. Embargoes on recruitment have already decimated many services.

And the waiting time for treatment is another target which can’t possibly be met. I’m waiting 10 months for treatment so far myself and it won’t be fixed by September. The minister is eager to point to his targets and the extra demands, talking points for the canvass and the chat down the pub.

Batten down the hatches to the membership as the noose tightens? Or a pre budget kite?

Dear Member,

As we come into the autumn Dáil session, Health, in common with other high-spending Government departments, is going to come under tight political and media scrutiny. So I thought it would be useful to give you an update on where we’ve got to in the Health Reform Programme.

Where are we on the path to a health system that serves the patient the way the patient is entitled to be served? And where are we with the significant pressures that we currently face?

You know that there is a financial overrun in the health service. But did you know that this year we’ve had a significant increase in activity levels:

   A 6 per-cent increase in hospital admissions through emergency departments
   A seven per-cent increase in inpatient discharges
   125,000 more medical cards than last year: A total of 1.8 million medical cards (the highest number in the history of the State) and we now have 125,000 GP Visit cards.

We’re clearly doing more. But we’re also doing better.

10,000 fewer people were on trolleys in emergency departments in the first half of this year compared to last year.

That’s important and real progress – we can find no comparable improvement in any similar healthcare system anywhere in the world.

It’s all the more relevant, given that €1.5 billion has come out of the system, over 6,000 staff have left, and we have a recruitment moratorium.

So – despite the most rigorous cutbacks ever – we’re treated increasing numbers of patients in the past year safely and without subjecting them to the chaotic trolley waits that some people had begun to assume were inevitable.

That’s due to the enormous commitment of people at all levels – from hospital porters to consultants, from nurses to radiologists. They’ve responded to the new requirements of, for example, the Special Delivery Unit, in a phenomenal way.  We will continue to need that commitment because we must and can do more to deliver services against a backdrop of diminishing resources.

This year, we’ve to find savings of around €700 million in our health services – massively difficult at any time, but much more so because of the increase in activity.

The search for savings must tackle inefficiencies and waste ahead of reductions in service. We’re first tackling:

–    Excessive sick-leave.

–    Use of agency staff.

–    Overtime levels.

The combined cost of these three in 2011 was roughly three quarters of a billion Euro.

Sick leave alone in costs approximately €280 million (very close to the level of the overrun). Agency staff cost €250 million, and overtime close to €240 million.

This must and will be tackled. The message has gone out, time and again, that managers must manage money and find ways to reduce costs long before they look at the option of service reduction.

Patients come first. That’s why I set a target for the end of last year that no one should wait over 12 months for treatment. That target has been met and was followed by a target that no one should wait for more than nine months. That target should be met by the end of September.

Let me also remind you that there is now a new Head of the Health Services in Mr Tony O’Brien. Over the last year he led the Special Delivery Unit, which has a clear track record for implementing improvements. I know that Tony O’Brien will not only manage the current difficulties with a keen sense of the importance of patients, but he will lead the health services through a period of major reform as we move towards the establishment of Universal Health Insurance

Behind the measurable improvements are less visible developments, like the fact that the use of beds in our hospital system is markedly better and major advances have happened, for example, in the treatment of strokes. All hospitals that receive stroke patients now have specialised Stroke Units to prevent death and serious disability every day. Our Acute Medicine and Emergency Care programmes will greatly enhance the treatment of patients in emergency care in hospitals.

We’re clearly positioned between a rock and a hard place: No choice but to cut costs while, on the other side, facing increased demand.  The next few months will be crunch time; tough decisions with difficult implications. I can make only one promise to you as a member of the Fine Gael Party: We’ll put patients first and we’ll put reduction in services last.

Over the next weeks you will hear opposition voices predicting calamity and catastrophe in the health services. The same voices were at work earlier in the year predicting the same doom and gloom in the context of the high level of staff leaving the health services through early retirement. But remember, they weren’t right then and they won’t be right now either.

I’m grateful for your support in meeting the serious challenges that lie ahead. Fine Gael as a party has never shied away from facing challenges in the public good. And remember, the greater the challenge, the greater the opportunity to give our people the health service they need and deserve.

Very best wishes
Yours sincerely

James Reilly TD
Minister for Health