Latest news with #BernardGloster
Irish Times
5 hours ago
- Health
- Irish Times
‘Constructive' talks take place between Minister and disability service providers, says department
Talks between Minister for Disability Norma Foley and service providers on problems faced by the sector have been described as 'constructive'. The Department of Disability said that the meeting on Tuesday formed part of ongoing engagement. Organisations providing specialist disability services have been concerned for some time about funding for the sector. The Irish Times reported in May that more than two dozen bodies providing services to tens of thousands of people warned there was 'an extreme risk' to their ability to expand services or, in many cases, sustain existing operations. [ Disability service providers warn of 'extreme risk' to operations and ability to expand Opens in new window ] In an unprecedented joint letter to Health Service Executive chief Bernard Gloster , the chairmen/women of 26 voluntary disability service providers – voluntary public service organisations and voluntary grant-aided bodies – said their ability to deliver existing services and meet the needs in their communities was under threat. READ MORE The letter said many organisations were facing such acute financial situations that their boards were 'concerned they may be in breach of the reckless trading provisions of the Companies Act'. The department said on Tuesday that Ms Foley, in conjunction with the HSE, had 'had a constructive meeting with disability services organisations ... and further engagements will be arranged over the coming weeks/months.' Taoiseach Micheál Martin has said the issue of disability is a top priority for his Government. However, while the amount of money allocated for specialist disability services has grown by €1.6 billion since 2020, the Government has recognised that some providers are experiencing 'funding, operational and governance challenges'. The letter sent to the HSE in May said that boards of public service disability organisations were 'having to operate in crisis mode'.
Irish Times
5 days ago
- Health
- Irish Times
HSE to introduce curbs on staff training and travel in bid to clip spending
The health service is to introduce new spending controls in an attempt to reduce expenditure in the months ahead. Areas such as staff travel, training as well as on the use of agency personnel will be affected by the move. The health service recorded a €218 million overrun in current spending in the first six months of 2025. The Health Service Executive said on Thursday that it wanted to break even for the year in terms of spending on services funded by the Department of Health. It said it was in talks regarding 'challenges' in relation to disability services, which are funded separately by the Department of Children . In a memo to his senior management on Tuesday, HSE chief executive Bernard Gloster said the organisation remained 'very challenged' concerning non-pay spending. He said he was introducing additional measures to be put in place with immediate effect. He urged senior managers to 'thoroughly review all areas of non-essential expenditure and implement additional financial measures' to achieve savings. Mr Gloster said new controls on spending limits would be introduced shortly. However, under new temporary rules, all expenditure valued at more than €1 million will in future have to be approved by the chief executive. An exemption will apply for capital payments already approved. All cost-incurring travel and subsistence not directly associated with clinical care is to be halted with immediate effect. The memo says the only exceptions were for regional executive officers overseeing their regions, the HSE's chief clinical officer dealing with patient safety issues and four senior executives who are required to attend critical engagements in Dublin. Individual staff training and attendance at conferences are to be deferred except where contracts have been entered into. Exceptions will be allowed in cases of statutory training required under legislation. International travel is to be cancelled even where this has been approved but the money not yet spent. The only exception will be where contracts have been entered into. No further use of agency workers outside of existing framework agreements will be allowed except for patient safety and care, 'where all other options have been documented as being exhausted at a minimum of hospital chief executive/manager or Integrated Healthcare Area manager level'. 'All authority to approve any management administration agency staffing ... is revoked as per recent instruction. This instruction is now confirmed without exemption,' the memo says. With some exceptions in areas such as digital and financial management, 'all external professional providers, including management consultancy and similar non-patient-facing services, are to be reduced by 50 per cent based on current use and expenditure'. The HSE in a statement on Thursday said it was 'extremely focused on cost control and the need to maximise savings without affecting patient care, and this week's memo to management is just the latest manifestation' of that. 'We are committed to achieving a cash break-even position for 2025 in relation to Department of Health-funded services and we have this week revisited our plans to do this, and believe we are on track. We are having separate discussions with the Department of Children, Disability and Equality in relation to challenges in disability services.' The HSE said 'any numbers taken from a midyear accounting exercise are just that – numbers without adequate context – and are not a measure of what we expect the full-year 2025 financial performance to be'.
Irish Times
5 days ago
- Health
- Irish Times
The Irish Times view on insourcing in the health service: not a longer-term solution
The Minister for Health, Jennifer Carroll MacNeill, is reviewing the use by the health service of third-party insourcing to cut waiting lists. It follows a review of the practice by the chief executive of the Health Service Executive, Bernard Gloster, who has recommended that it be phased out by the end of the year. What appeared to be a novel solution to reducing waiting times in the wake of the Covid epidemic has come to be seen as a costly problem. Under the initiative, introduced by then health minister Stephen Donnelly, private companies were encouraged to use spare capacity – in terms of trained staff and equipment – at public hospitals to provide services to patients on public waiting lists. The underutilisation that the initiative capitalised on was due in part to working hours and rostering limitations at public hospitals. The services were provided on a commercial basis and followed the precedent set by the outsourcing by the HSE of the treatment of public patients to private hospitals. The initiative succeeded in its primary objective of reducing waiting times, but its cost has proved problematic. Over ¤100 million was paid out in the 27 months to March to third party outsourcing companies, many of which are run by or employ existing HSE staff. READ MORE Concerns were raised at the outset about the possibility of conflicts of interest and the creation of perverse incentives whereby doctors and staff involved with third-party insourcing businesses stood to benefit from long public waiting lists. Some of these concerns appear to have been borne out, with a number of controversies prompting the review by Gloster. The Minister's dilemma is that while there may be political pressure to wind down the third-party insourcing initiative, there is even greater pressure to address waiting lists which are being driven ever upwards by demographic trends. The insourcing initiative is generally accepted to have made a material difference to waiting times. The HSE has agreed to new rostering arrangements for staff and hospital consultants which should see equipment and facilities used more efficiently, particularly over weekends and in the evening. However, this is unlikely to be sufficient to plug the gap created by abandoning third party insourcing. The existing reliance on private hospitals will most likely be exacerbated. The decision facing the minister is not a simple accounting exercise in which costs and benefits can be traded off. The HSE has clearly lost confidence in the initiative, and it is increasingly becoming a political liability for the Government. It may well have run out of the road, though phasing it out without adding to waiting list pressures will not be easy.
RTÉ News
06-07-2025
- Health
- RTÉ News
HSE chief highlights issues with third party insourcing
HSE Chief Executive Bernard Gloster has said an increase in dependency on third party "insourcing" in hospitals can create a number of problems. Mr Gloster said issues include disincentivising normal work delivery, limiting productivity and limiting opportunities to reform the service. Insourcing is where third parties or companies deliver care in hospitals outside normal hours. It is paid for by the State and, in some cases, is provided by HSE staff. The initiative was brought in to reduce long waiting list times for patients. Speaking on RTÉ's This Week, he said that a fundamental issue with third party insourcing is that a higher premium is paid, which means that some staff were being incentivised. Mr Gloster said that the majority of people who participate in insourcing are "good honest people" doing what they have been asked to do. However, he said that third party insourcing can create "significant conflict of interest" and "seriously undermine" compliance with procurement regulations. He said in a small number of instances, there have been indications of concern as to whether or not it is being used for what it is intended for. Mr Gloster said that we have "developed a dependency" on something that is a disincentive to the other types of reform, like the public only contract being distributed beyond the five-day week, because the same staff are involved. He said he provided a HSE report on the issue of insourcing and outsourcing to Minister for Health Jennifer Carroll MacNeill last Monday, which she has published. He said the minister has committed to coming back to the Oireachtas Health Committee by the end of this month with a set of decisions and actions in terms of reducing dependency on third party insourcing. Mr Gloster agreed that it is his strong recommendation that it be ended. The HSE report, carried out by Mr Gloster, found that 83 current and former staff are directors in 148 companies providing this care. He said that the holding of a company directorship is not illegal but he said it brings a level of "perverse incentive" that is not sustainable. Asked if third party insourcing was stopped too quickly and would it push waiting times up, he said that this is why he has recommended a longer time frame to phase it out with additional controls and oversight. In relation to audits on three hospitals over concerns about the use of these waiting list funds,he said that he has to wait for the internal audit reports to see if the complaints have any substance. He said the purpose of the report he has given to the minister is to come to a sensible set of actions, aimed at improving waiting list management and reducing risks. Asked if money was being used appropriately for outsourcing initiatives, he said that oversight, corporate governance and the avoidance of conflict of interest is easier in outsourcing arrangements. Commenting on the CHI internal report being referred to gardaí, he said there were issues in relation to the individual care of people and how they were or were not managed on waiting lists. Asked if he was confident that CHI was the right entity to manage the new children's hospital he said that he has "every confidence" in the new CHI CEO Lucy Nugent. However, he said is in no doubt that this is an entity that faces a scale of challenges and historical and cultural issues.
Irish Independent
04-07-2025
- Business
- Irish Independent
Three companies paid €71m to reduce hospital waiting lists – one of which received more than €54m, HSE figures reveal
One of the companies was paid in the region €54.6m, according to the figures provided to the Oireachtas health committee. The other two were each paid €10m and over €5m. The figures supplied to the committee come after HSE chief Bernard Gloster said earlier this week it was planned to phase out of the use of these companies over the next year. They are hired by hospitals and the wider health service to help reduce waiting list backlogs. He told the health committee that a trawl carried out by the HSE covering 27 months found around €100m in total was paid out to these companies during that time employing the external companies to carry out waiting list work using public facilities in the evenings and weekends. The HSE review – which followed recent controversies – also shows that 83 directors of these companies are current or previous employees of the HSE. Some 23 are current employees – working in the HSE while also serving as directors of companies hired by hospitals to reduce backlogs of waiting list patients. He told the committee earlier this week he planned to phase out this form of insourcing in public hospitals by the end of June this year and it was not possible to do it immediately. These companies have grown in 'level and scale. We took our eye off the ball. We need to unwind it,' he told the committee. He add that the 'only way to change it is to stop it.' The winding down must be done 'sensibly', he added. He pointed out there is nothing unlawful about being a company director and there are obligations under the Standards in Public Office or employment contract terms. The review had found an over-reliance on these external companies – several of which had links to hospitals. He said the plan is to introduce more safeguards around them and he is to work with Health Minister Jennifer Carroll MacNeill on strengthening these. The review examined 148 companies which had 365 directors in total and found 93 matches with current or previous HSE employees. The implications for removing these companies from carrying out the work is that there is potential for having to use more private hospitals to treat public patients. The aim is to increase productivity through routine work.
