‘No proof Trust care level same post-cuts’

THERE is no evidence service quality has been maintained following the closure of residential care homes and staff reductions carried out as part of a range of Western Trust savings initiatives according to a new report by the Northern Ireland Auditor Office (NIAO).

The NIAO report says slashing managers and administrators, reducing staff at Gransha and closing two residential care homes - amongst other measures - all made sense as efficiency saving concepts but there was no evidence to show service quality had been maintained.

Auditor General Kieran Donnelly has just published a Review of the Efficiency Delivery Programme, which was legislated for in the 2008-11 Budget and required all government departments to deliver 8 cumulative efficiency gains of three per cent a year over the period.

These efficiency savings were supposed to be resource-releasing and supposed not to result in cuts to priority frontline services.

But in Part Three of his review dealing with the Overall Management of the Efficiency Programme, Mr Donnelly, wrote that it was impossible to tell if service delivery was maintained across a range of Western Trust initiatives because not enough evidence was available.

He also intimated that the Department of Health, Social Services and Public Safety (DHSSPS) was guilty - alongside other Executive departments who merely passed on percentage reduction targets to arms-length bodies like the Western Trust and left it at that.

He wrote: “There is scope to improve governance arrangements. Departments had limited oversight of their Arms’ Length Bodies’ efficiencies and in many cases simply passed on a percentage budget reduction without any underlying analysis.”

The cuts, however, were substantial as Mr Donnelly elsewhere explains: “In many cases departments reduced funding of their Arms’ Length Bodies (ALBs) by a flat rate percentage.

“For example, in the health sector, DHSSPS reduced HSCTs budgets by 2.5 per cent (2008-09); 3 per cent (2009-10) and 3.5 per cent (2010-11) - this amounted to a total reduction of £244.4 million for the HSCTs (Belfast HSCT £91.7 million; Southern HSCT £36 million; South Eastern HSCT £37.1million; Northern HSCT £43.6 million and Western HSCT £36 million).”

But it appears the failure to carry out an underlying analysis of the budget cut implications was true across a range of Western Trust measures.

For example, a proposal to reduce administration and management posts across the Western Trust as part of the Review of Public Administration (RPA) savings made sense because it was thought it would reduce the number of paid-for posts.

But there was ‘no full run of expenditure data including a baseline position and a position for each subsequent year.”

Neither was there a “full run of activity/output data.”

When the Trust was asked for “evidence to show that service quality had been maintained” it did not have evidence specific to this particular measure. However, “wider quality assurance processes” were in place.

The Audit Office said that in terms of its overall judgement of the proposed cuts to managers and administrators there was “insufficient information to determine” a judgment.

NIAO also said the decision to invest in home help and rehabilitation and to close two residential care homes in the Western Trust made sense as an efficiency saving.

It is also found a full run of expenditure and baseline position was available from 2008-11 for this move, alongside a full run of activity and output data.

But there was no evidence that the service quality had been maintained, though the NIAO said the “sector is subject to an inspection regime.”

Once again there was “insufficient information to determine” and overall judgement on the closed residential homes.

Information gaps were also found on the reduction of the number of midwives at the Erne Hospital and the closure of the acute medical ward in the Tyrone County hospital.

Both moves were found to conceptually make sense as savings but once again the gaps meant that the NIAO could deliver no “overall judgements.”

Finally, staff reductions following the restructuring of acute admissions wards and psychiatric intensive care units at Gransha hospital in Londonderry and in the Tyrone and Fermanagh hospital, were also found to make sense “conceptually.”

Some high level data was available, but there was no evidence to show that service quality had been maintained.

There was once again, however, “insufficient information to determine” an overall judgment.