State's NTPF suspends special funding at CHI over controversy around abuse of waiting lists
The State fund responsible for reducing waiting times at public hospitals has suspended all funding for private services at
Children's Health Ireland (CHI)
hospitals under 'insourcing arrangements' over concerns at the group.
The move follows the controversy around a hospital consultant who allegedly breached
HSE
guidelines by referring patients he was seeing in his public practice to weekend clinics he was operating separately.
The
National Treatment Purchase Fund (NTPF)
has suspended all funding for 'insourcing arrangements' at the children's hospital group on foot of concerns raised about how such schemes have been operated in the past.
The NTPF aims to cut waiting times by paying private practices to treat patients on public waiting lists.
READ MORE
Insourcing is where public hospital facilities and staff, such as in CHI, are funded by the NTPF to provide additional services, outside core working hours, to treat those waiting longest for care.
The NTPF receives more than €200 million each year to pay for the treatment in the public and private systems for patients on long waiting lists.
On Tuesday, the fund said that following 'serious concerns' raised over an internal report drawn up by the children's hospital group in 2021 - but not published or circulated - it had 'immediately placed a temporary pause on all insourcing work with CHI'.
It said it had initiated 'a comprehensive review of all insourcing work with CHI to gather the necessary assurances regarding compliance, value for money and appropriate use of NTPF funding mechanisms'.
The NTPF does not provide details of payments made to individual hospitals so the amount provided to the CHI group over recent years is not known publicly.
The fund said the key criteria covered for insourcing programmes include that the funding is targeted at the longest waiting public patients.
It also stipulates that all insourcing activities are being carried out strictly outside of core activity and are not displacing or overlapping with services already funded under the HSE's national service plan.
No costs already funded by the HSE, including capital or core-funded staff costs, are allowed to be included in NTPF reimbursement claims.
All staffing arrangements must be line with public pay policy and comply with HSE consolidated pay scales for core hours, overtime and premium payments.
The NTPF said that it was 'liaising with CHI at the highest level' to obtain and review these assurances and is in close contact with the Department of Health and the HSE.
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Irish Times
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Letters to the Editor, June 7th: on nursing home revelations, Trump versus Musk and bird droppings
Sir, – It is 20 years, almost to the day, since RTÉ broadcast the Prime Time Investigates documentary which revealed the horrors of Leas Cross nursing home in Dublin. On Wednesday, further outstanding investigative journalism by RTÉ revealed yet more horror stories in Ireland's private nursing home sector. I have no words to adequately describe the anger, profound sadness and deep frustration I felt as I watched frail, vulnerable, elderly people being denied the most basic care. As I listened to frightened residents begging and pleading for help, I also felt an overwhelming sense of the deepest fear. READ MORE My mother lived with dementia for 20 years. She has a strong family history of dementia and all her siblings have either succumbed to, or are living with, Alzheimer's disease. I cared for my mother at home for many years. I am forever thankful that she received excellent quality care, and extended care, in both our acute and voluntary hospitals. Developing dementia is one of my greatest fears. I have no family. There will be nobody to fight for good care for me, or to advocate for me, should I also succumb to dementia. When I watched frail elderly residents with dementia being treated so horrifically on the RTÉ Investigates documentary this week, I despaired. Those residents were the victims of blatant abuse. Residents with advanced dementia would most likely be unable to accurately explain their experiences to anybody, or to identify their abusers. That also makes them easy targets for such abuse. I concluded that, should I ever be diagnosed with dementia and reach that stage of illness and dependency, I would rather not be alive than be at the mercy of such so-called 'care providers'. Twenty years after Leas Cross such horrors are still happening. What does it take to make this stop? Or will this latest horror simply result in more transient outrage, more eloquent statements and yet more empty promises, until the next time? Is there always going to be a next time? – Yours, etc, BERNADETTE BRADY (PHD), Rathfarnham, Dublin. Sir, – The RTÉ Investigates programme, Inside Ireland's Nursing Homes, was truly disturbing. RTÉ and all who contributed to the making of the programme, both to camera and undercover, deserve our thanks. It does however raise some important questions which a follow-on programme might wish to address. Twenty-five years after the Leas Cross scandal, and the follow-on establishment of the Health Information and Quality Authority (Hiqa), how come care in congregated settings is increasingly provided in large for profit facilities (a worrying trend to which Hiqa has drawn attention) and what difference would it make if the Health Service Executive (HSE) were to build and run more such facilities? How come private and voluntary (non-HSE) nursing homes are not part of the overall planning process for integrated services in the six new regional HSE organisations, despite a clearly identified need to improve clinical governance across the sector as suggested by the expert group on nursing homes which reported during the Covid pandemic? Where is the evidence of follow through on all the recommendations for the development of a wider range of alternatives to nursing homes, including the development of small scale 'Household / Teaghleach'models of nursing home and congregated care? Why is the National Treatment Purchase Fund (NTPF), essentially a medical procedures agency, still involved in 'purchasing' care for older people through a nursing home support scheme (Fair Deal) administered by the HSE across all nursing homes (most of which it does not control) while the regulator, Hiqa, has no role in regulating the payment levels to those nursing homes? 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Finally, for all those many staff currently providing care in nursing homes to the highest standard they possibly can, in the often difficult circumstances in which they find themselves, it would be helpful if they could rely on a public system of support and guidance, including clinical support and governance, to deal with issues and concerns at short notice rather than having to await an occasional inspection from the regulator followed by a report some while later. Regulation and inspection are important but they are no longer enough. Practical supports to encourage quality care are far more likely to pick up on issues and have them addressed as they arise. – Yours ,etc. MERVYN TAYLOR, Stillorgan, Dublin. Sir, – The RTÉ Investigates programme laid bare the inhumane treatment of vulnerable residents in private nursing homes – many of whom are paying exorbitant fees of €1,400 per week. At such a staggering cost, these individuals could instead receive dignified, high-quality home care in the comfort of their own communities. That these abuses persist is a damning indictment of systemic failure. Hiqa, tasked with safeguarding standards, has clearly failed residents, families, and the State. Paper-based inspections and sporadic visits are not enough to prevent cruelty behind closed doors. If we are serious about accountability, Hiqa must have a permanent, on-the-ground presence in every facility, with 24/7 monitoring via live video feeds covering all areas – excluding only private bathrooms for dignity. Modern technology makes this feasible; what's lacking is political will. Why not implement this? If prisons and childcare centres can adopt stringent oversight, why not nursing homes, where our most fragile citizens reside? Until real-time transparency is enforced, families will never trust that their loved ones are safe. 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