Alarming risks to mothers and babies, elderly patients and the mentally ill have been identified in a secret HSE report on the effects of recent cutbacks to health services.
The damning report, seen by the Sunday Tribune, also reveals that standards of breast cancer treatment have fallen and that the "risk of clinical errors" has increased because of cutbacks and an embargo on recruiting new staff.
The report was completed by the HSE West in recent weeks. Based on a survey of four main service areas – acute hospitals, community nursing services, mental health services and older people's services – the report shows the shocking reality of how frontline services are directly affected by the ongoing recruitment embargo. Its findings are revealed as government spending on health looks set to be slashed by a further €600m in the December budget.
This is less than the €1bn cut in last year's budget but it is still certain to further impact on frontline services. Seventy per cent of the health budget is pay related and, under the Croke Park Agreement, the government cannot repeat last year's public-sector pay cut. It will therefore have few options other than further cutting frontline services.
The HSE report says the ability to comply with Health Information and Quality Authority (HIQA) standards in areas such as infection control, decontamination, hygiene, breast cancer standards and care of the elderly has been "seriously curtailed" in acute hospitals.
"Notable increases in adverse incidents were directly attributed to staff shortages and staff having to cross cover, which increases the risk of clinical errors by reducing continuity of care and increasing caseloads," it says.
In maternity hospitals, "activity far outweighs the staffing levels, posing increased risks to mothers and babies", the report reads. Patient care is "compromised".
In mental health services, the report reveals "an increase in the number of violent incidents in the service, partly as a result of the low staffing levels and inexperienced staff". The Mental Health Act 2001 regulations are being breached, it says.
In public-health nursing there is a risk to child health in the absence of core developmental assessments so "problems go unidentified and appropriate referrals to speech therapy, psychology, etc, are not made". The reduction in public-health nursing services also poses a risk to post-natal mothers and newborn babies.
The report reveals an "increased risk of falls and adverse events" for patients in older people's services, and a drop in staff employed to supervise elderly patients' exercise. There are also longer waiting times for respite and rehabilitation beds for the elderly. HIQA action plans and hygiene audit plans are not being developed.
The report has found that frontline services were more affected by the recruitment embargo than management or specialist grades, as 67% of all vacancies arise in frontline staff grades.
While the report focuses on the HSE West region, one of its key considerations advocates that reports "could be replicated in other HSE areas therefore providing a full national perspective" of the effects of the recruitment embargo.