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BreakingNews.ie
26-06-2025
- Health
- BreakingNews.ie
Consultants question Department of Health productivity stats
Consultants have questioned the validity of new Department of Health metrics which calculated that the doctors are not as productive as they were 10 years ago. It comes as the Minister for Health said she wants to hold hospitals and individual specialties to account over turning increased investment into productivity. Advertisement New analysis of HSE data shows that consultants could have held 1.5 million more appointments last year if they were operating on the same productivity as 2016. A senior official at the Department said it wants to understand the 'productivity conundrum' where a 'great increase' in the total number of whole-time equivalent (WTE) consultants had occurred against a fall in outpatient appointments per practitioner. The data shows that a 70 per cent increase in WTE consultants between then and 2024 was met with just a 20 per cent increase in outpatient appointments – meaning a lower average per individual practitioner. If the consultants had been operating at 2016 levels of productivity, the Department contends they could have held 40 per cent more appointments than they actually did. Advertisement The Irish Hospital Consultants Association (IHCA) cautioned that data 'must be presented in the proper context'. It said it welcomed a focus on transparency and performance but said the number of doctor consultations is not regarded as a valid measure of productivity. The IHCA said this is because consultations differ in complexity, duration and impact, and the metric 'fails to reflect the significant volume of care provided to hospital inpatients' as well as time spent on diagnostics, research, clinical governance and administration. It said: 'Any productivity analysis must seek to reflect the value and outcomes associated with care, not merely the volume.' Advertisement It said there had been a marked increase in complex, time-intensive direct care delivery by consultants. It said the issue was fundamentally a capacity crisis and framing it as a productivity issue around one group of staff runs the risk of setting false expectations and undermining collaborative efforts. The IHCA said: 'We are absolutely committed to doing more — but we cannot do it alone.' A new data dashboard from the Department of Health's also allows for comparisons on waiting lists and other performance indicators. Advertisement While the tool allows specialties and hospitals to benchmark their performance against their peers, the department said the dashboard is a 'learning tool' and 'not a stick to beat anyone with'. A senior official stressed that the initial focus of the dashboard was about transparency and 'putting a spotlight' on the ability to convert resources into services for patients. However, there are performance management expectations in health service reforms – with the department figure saying that anyone making major public investment in healthcare would want to be assured that the site has demonstrated an ability to convert investment into improved services. There were 1,812 WTE consultants in 2016, rising to 3,061 in 2024. Advertisement However, the number of appointments per consultant has fallen from 1,686 in 2016 to 1,209 in 2020 – where it appears to have roughly plateaued into the present day. Using the correlating 3.1 million outpatient appointments in 2016, the department said this meant the same efficiency could have resulted in 5.2 million outpatient appointments last year. However, this is 1.5 million above the actual figure of appointments which stood at just 3.7 million in 2024. Department officials said the dynamics behind that discrepancy have yet to be explained, adding that Ireland would have a 'vastly more effective service' and 'massive reductions in waiting times' if 2016 productivity levels had been maintained. Acknowledging that consultants may find the blunt comparison unfair given the impact of Covid-19 on the intervening years, officials still said the health service seems to be 'a bit stuck' on the roughly 1,200-appointments-per-consultant figure. A department official said it 'definitely warrants a major effort' to push back towards previous productivity levels – even if 2016 rates are no longer realistic. 'The productivity and savings taskforce is really determined that we get to grips with productivity in these kind of very benign and positive times in terms of investment and expansion, because it will be vital if we ever have to deal with more, more challenging fiscal circumstances.' One of the other key metrics measured by the dashboard is 'composite activity output', which attempts to distil years-long increases in productivity across different types of care into a single figure to allow for comparisons against workforce and expenditure increases. Officials said it showed that some hospitals are 'notably better' at converting their input into activity, adding that they wish to determine the reasons for that. The department said the dashboard provided an entirely new view on data which had not been previously used sufficiently well to inform service planning and development. Minister Carroll MacNeill said the dashboard was an effort to present 'the best transparency we possibly can' on hospital activity. She said there had not been enough focus on how hospitals are locally managing increased investment in the most efficient way for better patient outcomes. Ms Carroll McNeill said: 'For too long hospitals have had the opportunity to regard themselves as independent republics. 'They are very much part of a State system that is funded by the State, and it's a reasonable and appropriate process to shine this light in relation to their activity.' She said it could not be the case that increased investment in health did not result in increased efficiency. Ms Carroll McNeill added: 'That means more outpatient appointments, that means better use of surgical capacity, that means better use of diagnostic capacity. 'And I think the productivity dashboard here is a way of making sure that we are holding hospitals and individual specialisms to account to manage themselves better.' Other potential uses for the dashboard include assisting GPs in deciding where to refer patients, having consulted the waiting lists trends in their region. Officials also believe that moves to a fuller seven-day working week will improve productivity.
Irish Examiner
26-06-2025
- Business
- Irish Examiner
Letters to the Editor: Climate action — we need to move from rhetoric to action
We're going to be hearing a lot about 'just transition' in the coming months. At week two of the UN Bonn climate talks, which will shape the road to the Cop30 climate summit in Brazil, governments are starting to engage with the idea of a just transition. This is to be welcomed. The climate crisis is no longer a distant threat, but a burning reality for millions. Yet, the climate burden continues to fall unfairly on the world's poorest communities and those who have contributed least to global emissions and climate change. A just transition will ensure that the shift to a low carbon economy is fair, inclusive, and delivers job security and affordable food and energy access to the most vulnerable. But it also means rich nations stepping up with grants-based finance to support communities and countries most affected by climate meltdown, countries burdened by debt and denied climate finance. It also means a commitment to a serious shift away from fossil fuels. While the level of fossil fuel finance had been declining since 2021, last year saw two thirds of banks increasing their financing by a combined $162bn — a period when the world experienced its hottest year since records began. Ireland is shamefully playing its part in fossil fuel financing. A recent report by ActionAid Ireland and Trócaire revealed that, as of June 2024, an astonishing €3bn in fossil fuel investments were held by Irish-based financial institutions. Even more disturbing, 91% of that investment is tied to companies actively expanding fossil fuel operations in direct defiance of international scientific consensus on the need to limit global warming to 1.5C. Without a clear agreement on just transition at Cop30, the energy transition risks deepening inequality and further destabilising fragile economies. But a just transition framework, backed by funding, strong labour protections, and international co-operation, can turn this challenge into an opportunity for shared prosperity and resilience. It was encouraging to read Ali Sheridan, the chair of Ireland's Just Transition Commission, an independent advisory body established by the Government last year, affirm recently that it's essential any climate action must be fair for all. The world must move beyond rhetoric to action. A fair climate future must work for everyone, not just the privileged few. Karol Balfe, CEO, ActionAid Ireland, Dublin Criticism towards IHCA unwarranted Sarah Harte asserted in her piece ('The Gaza catastrophe is testing Ireland's conscience – and its credibility', June 11) that the Irish Hospital Consultants Association (IHCA) has taken a position of 'deafening silence in calling out genocide' in relation to Israel's systematic campaign of violence in Gaza. Such criticism is completely unwarranted. The IHCA has issued five statements since the beginning of 2024, condemning the unlawful destruction of hospital infrastructure and subsequent targeting of healthcare practitioners by the Israeli military. We are unequivocal in stating that the actions of the Netanyahu government and Israeli Defence Forces equate to crimes that contravene international law; accordingly, the International Criminal Court has issued an arrest warrant. We agree with the Government's assessment that these crimes against humanity include a genocide against the Palestinian people. In tandem with these repeated statements, I wrote for The Medical Independent a piece entitled 'We cannot be bystanders to genocide' (May 12, 2024), long before any Western government named it as such. In my first public address as president of the Irish Hospital Consultants' Association, I called for an end to the 'targeting of medical staff and hospital infrastructure in plain sight'. Several of our members are working on the frontline in Gaza hospitals, coming under live fire. We cannot be silent when it is these colleagues, their patients, and our Palestinian peers facing these desperate circumstances every day. We will always defend the right of healthcare practitioners to deliver care without fear of death or violence, and for their patients to live healthy dignified lives, whether that be in Ukraine, the Middle East, or any other conflict. Gabrielle Colleran, President, Irish Hospital Consultants Association, Dublin 14 You are as old as how you feel 'You are as old as you are portrayed' may be true ( Editorial, Saturday 21), but what about hitting the dance floor well in to your 80s and 90es as reported by an international newspaper last week about a group of Belgian nursing home residents as they danced and jived to 'bass-heavy' music among their much younger counterparts at a nightclub in central Brussels? You are as old as how you feel and your attitude to doing new things. 'There's no real age limit for knowing how to party, ' says the manager of the nightclub where Papy Booom — a Belgian non-profit that aims to address loneliness among older people and create more opportunities for fun — held their night out. Bring it on I say! Tom McElligott, Listowel, Co Kerry Industry crying out for tradespeople I have spent 39 years in the construction business, 33 of them as a self-employed contractor. To me, the elephant in the room is the lack of tradesmen and also general operatives in this sector. When I started out in 1986, we spent our first year in Anco — a government-based training facility and Cork RTC, now MTU. It was a great grounding for green lads starting out. Unfortunately, now we are moving all our children into college because of their popularity and encouragement from secondary schools to encourage kids to go there. There is also a perception out there, from parents mainly, that the construction industry is beneath their child. It's OK for them to train as a engineer/architect/quantity surveyor or possibly some of the physically easier trades of electrical or plumbing. The reality is we are crying out for groundsman, carpenters, blocklayers, and plasterers — the latter two are not a dying trade and will become extinct in the next 10 years or less, which will stagnate the construction industry. What needs to happen is for the Government to financially incentivise builders and tradesmen to employ and train young people. What's your view on this issue? You can tell us here At the moment, tradesmen as a whole — there are exceptions — aren't interested in putting the time into training an apprentice. The Government also needs to hold the revenue received from the construction industry, and use it to reinvest in the sector when there is a downturn in the economy and invest in public buildings such as schools, libraries, and hospitals to get better value for money during those times. More importantly, it will keep our building workforce in jobs. This process would encourage young people to go into the sector for stability, and also make parents more content in seeing their child enter the sector. Finally, a strong advertising campaign is needed to get young people to join the industry. Working in the industry can be deeply satisfying, working with your hands and brain and getting a lot of satisfaction. If you are prepared to work hard, listen, and learn, there are great opportunities to earn a good living and become financially secure after a few years of working, compared to going to college and having massive financial outlays in the process and struggling financially in poorly paid jobs at the end of your four or five years of college. Stephen McGrath, Fermoy, Co Cork Landing big tax bill The Connacht Tribune recently reported the dismay of Mayo councillors at the €385,000 that their council must pay to Revenue for their unused residential zoned land. If a council with an annual budget of €213m for 2025 alone cannot make use of its lands, what hope is there for mere mortal private developers without the fairy god-exchequer to fund them and who have things like tax to deal with. Local authorities have cumulatively paid over €11m in residential zoned land tax (RZLT) — clearly, councils have land they are not making use of. Remember that they have deemed their own land ready and suitable for housing. The Land Development Agency is seeking powers to buy private land, but this is a distraction from the real land hoarding done by the many arms of the State itself. Politicians created the ridiculous RZLT. That they find their own councils on the receiving end is a most pleasing karma indeed. Alex Wilsdon, Dublin Rd, Kilkenny Read More Letters to the Editor: My mother had a happy experience of residential care
