Health services across Europe face cuts as debt crisis begins to bite

BMJ 2011; 343 doi: (Published 18 August 2011) Cite this as: BMJ 2011;343:d5266
  1. Muiris Houston1,
  2. Michael Day2,
  3. Maria de Lago3,
  4. John Zarocostas4
  1. 1Galway
  2. 2Rome
  3. 3Madrid
  4. 4Geneva

As the eurozone debt crisis spreads to Italy and Spain, BMJ correspondents investigate its effects on health services in four of the hardest hit countries

Health budget faces severe cuts in Ireland

Muiris Houston, Galway

Ireland was one of the first countries in the “eurozone,” the 17 European Union member states that have adopted the euro as their sole currency, to hit financial problems, leading to public sector cuts that have forced bed closures and a recruitment embargo on frontline posts.

After last year’s financial bail out by the International Monetary Fund and the European Central Bank, the Irish government no longer enjoys financial autonomy. On top of already stringent cuts to public services, at least €3.5bn (£3.1bn; $5bn) must be cut from next year’s budget. The health service budget is expected to be cut by up to €1bn in 2012.

But cost over-runs in excess of €200m in the first six months of this year have led to the recent closure of hospital beds. The Mid Western Regional Hospital in Limerick has already overspent by €21m this year and has closed 25 acute care hospital beds in response. The hospital has experienced a sharp rise in demand after the closure of a smaller acute hospital in the region two years ago. Almost 20% of patients were waiting between 12 and 24 hours to be admitted through the regional unit’s emergency department even before the latest cutbacks.

Although a general public service recruitment embargo has been in place for more than a year, the Health Service Executive (HSE) last week told unions that it was now “pausing” all recruitment. The decision means that around 1000 posts, which until now have been exempt from the government’s public sector recruitment freeze, can no longer be filled. These include frontline posts such as social workers, therapists, doctors, and nurses.

The HSE said, “This …

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