Latest news with #JenniferCarrollMacNeill
Irish Times
10 hours ago
- Health
- Irish Times
The Irish Times view on the future of CHI: finding the right way forward
The Government is grappling with the question of what to do about Children's Health Ireland (CHI) after a string of controversies. There is no single ' right' answer to this dilemma, with the various possible routes forward all having pluses and minuses. But it is clear that doing nothing is not an option for the Minister for Health, Jennifer Carroll MacNeill, who has already appointed a number of new members to the CHI board. In moving forward, it will be important to keep a forensic focus on a few key issues which have emerged. This is a multi-faceted problem and there is no single, or easy, solution. And this was underlined by recent reports of a toxic culture in one CHI hospital, with multiple complaints about certain consultants. An obvious issue is that the CHI governance structure has not operated properly, failing to spot problems and also not providing adequate information to the HSE and the Government. One option to tackle this is to bring CHI fully under the aegis of the HSE which, of course, has had its own problems. Whatever exact structure is chosen, it is essential that CHI is operated in a way that reflects its reliance on taxpayer funds. A weakness of the voluntary hospital system, of which CHI is a part, is a lack of clarity about lines of accountability. This may even suit politicians and the HSE to some extent, as there is always someone else to blame. But it cannot continue. READ MORE Whatever new structure emerges must deal with this. And it needs to recognise that appointees to board such as the CHI need to be adequately remunerated for the responsibilities they take on. Public service has driven many who have taken on such posts. But proper professional structures are important. The controversies also raise questions about clinical governance in CHI, under new structures set up in 2008. This process is meant to ensure patient safety. Clearly, in the case of the use of unauthorised implants in spinal surgery and unnecessary hip operations, there were serious failures. A separate clinical issue has emerged about one consultant's use of the National Treatment Purchase Fund (NTPF). It is essential that, whatever checks are needed , this must not result in undue further delays in appointments and operations for children. No doubt these separate incidents will also lead the Minister to reflect on the wider failure of the healthcare system to deliver an adequate return for increased spending, raising issues about productivity and also the overall system of clinical management. There have been improvements in the healthcare system , but also areas where services are well below where they should be . And the recent string of disturbing scandals further underlines the need for reform.
Irish Times
16 hours ago
- Business
- Irish Times
National Treatment Purchase Fund seeks assurances from all hospitals that rules of waiting-list schemes being followed
The National Treatment Purchase Fund (NTPF) is seeking assurances from all hospitals that rules governing the operation of waiting-list initiatives that it funds are being followed. The move follows concerns raised about special out-patient clinics run on Saturdays in the children's hospital group, Children's Health Ireland (CHI). On Tuesday, the NTPF suspended funding to CHI pending inquiries into issues raised in an internal report, which was originally drawn up in 2021 but never published or circulated to senior figures elsewhere in the health service. The NTPF said on Tuesday: 'Following serious concerns raised over the 2021 CHI report, the NTPF immediately placed a temporary pause on all insourcing work with CHI. It has 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.' READ MORE Minister for Health Jennifer Carroll MacNeill suggested on Wednesday that this NTPF pause on funding would continue for a week or 10 days as it sought assurances on the operation of waiting list initiatives at the group. It is understood that the NTPF has now sought assurances from all hospitals. The current pause on funding, however, applies only to CHI. The NTPF will this year receive about €230 million from the exchequer to buy treatment in both the public and private systems for patients on waiting lists. The NTPF, as part of its work, pays for treatment for those waiting longest to be provided outside core working hours in public hospitals by staff working in their own time. Hospitals and staff are paid additional sums for taking part in such initiatives. This process is known as 'insourcing'. Insourcing programmes are targeted at the longest waiting public patients. The internal CHI report said there were 'significant concerns about prudent and beneficial management of NTPF funding and a lack of oversight in relation to access schemes that were not in keeping with the memorandum of understanding'. The report highlighted 179 children seen at five special outpatient clinics operated by a consultant at CHI over five Saturdays. The report questioned whether such clinics were needed and whether there was capacity elsewhere in the public system for the children in question to be seen. The consultant concerned received €35,800 in additional funding from the NTPF. In the Dáil on Thursday, Labour Justice spokesman Alan Kelly said CHI should be subsumed into the HSE. This is 'about the only outcome that is in any way possible' and 'it needs action quick'. He said: 'we need to have confidence in governance and the day-to-day running, because the culture in CHI seems to be absolutely atrocious.' He also called for the NTPF to be closed down in an orderly manner with a full audit of its operations and who benefited. 'I don't believe that the NTPF is or should be in place in a country where the healthcare system is working,' he said, adding 'we should be in a situation where those who need treatment the most are prioritised based on need. 'It shouldn't be a case of: we can't deal within the public system, so we'll actually pay off others to do the work.'
Irish Independent
a day ago
- General
- Irish Independent
94pc of Wicklow pharmacies sign up for free HRT scheme
If you have a prescription for HRT from a GP, registered nurse or midwife and you are registered for the Drugs Payment Scheme or have a medical card, you can get free HRT medicine from a pharmacy participating in the Free Hormone Replacement Therapy scheme, of which 94pc of Wicklow pharmacies have signed up. Women can identify their nearest pharmacy to them that is providing the service by using the HSE pharmacy finder, at Praising Wicklow pharmacies for their 'extremely positive' uptake of the scheme, Wicklow TD Edward Timmins said he was grateful to Health Minister Jennifer Carroll MacNeill for engaging with all stakeholders so successfully to 'deliver this medication free of charge for the many women around the country who need it'. 'The majority of pharmacies across the country are participating in this scheme, and this figure is increasing daily, meaning that all women will be able to access this free medication in a pharmacy convenient for them,' he said. 'In Wicklow, 94pc of pharmacies will offer the free medication to women, which is extremely positive. 'It's important to note that the new arrangement includes a pharmacy dispensing fee, so medication will be completely free. 'The symptoms women encounter during perimenopause and menopause are varied, and women's lives can be hugely impacted,' he added. 'HRT is such an important medicinal regime for women and can positively improve their lives and make daily living much easier. This scheme is transformational for women. I commend the pharmacies here in Wicklow who have joined the scheme to continue to provide vital healthcare to our communities.'
The Journal
a day ago
- Health
- The Journal
HSE refers unpublished Children's Health Ireland report to gardaí
THE HSE HAS decided to refer an unpublished report detailing concerns at Children's Health Ireland to gardaí. The internal investigation, the details of which were first reported by the Sunday Times and subsequently seen by The Journal and other media outlets, detailed concerns about waiting list initiatives and work culture at a hospital run by CHI. It detailed how a consultant was paid €35,800 by the hospital after money was received from the National Treatment Purchase Fund (NTPF) to help cut long waiting lists. The CHI report looked at concerns relating to access to services for patients waiting the longest on lists, as well as relationships between staff at one of its hospitals. Earlier today, Minister for Health Jennifer Carroll MacNeill called for a redacted version of the report to be released in the public interest. Speaking on RTÉ Radio One, she said she met with the Attorney General last week and was informed that she does not have a 'legal basis to publish the report' as it is the 'property of CHI'. Advertisement 'Nevertheless, I think it's important that a redacted version of this report is published in the broader public interest,' the minister said. She said she wants 'maximum productivity' in the public healthcare system and to 'remove incentives' which could hinder that. CHI said this week that the internal report, which was carried out in 2021 and 2022, led to recommendations that 'have been implemented and are ongoing'. It said the reported five out-patient clinics did not take place in the consultant's private rooms but 'occurred in a public clinic, in one of its hospitals, on a Saturday'. 'The NTPF funded the hospital for this waiting list initiative and there was no charge to patients,' said CHI. 'This was over and above the Consultant's contractual hours. There are no direct payments to CHI staff from NTPF.' The report states that the consultant saw patients in 10-minute slots, shorter than the time they would spend with clinicians in the public, non-NTPF clinics. HSE CEO Bernard Gloster has said he was 'shocked' by the report and suggested he could refer 'the matter to the gardaí'. Readers like you are keeping these stories free for everyone... A mix of advertising and supporting contributions helps keep paywalls away from valuable information like this article. Over 5,000 readers like you have already stepped up and support us with a monthly payment or a once-off donation. Learn More Support The Journal
Irish Times
a day ago
- Health
- Irish Times
Children's Health Ireland report referred to gardaí
A report on waiting list irregularities and a 'toxic' work culture at a hospital run by Children's Health Ireland (CHI) is to be referred to gardaí , the Cabinet committee on health has been told. The report, which not been published but has been widely reported in some media outlets, has caused shock in Government over the past week. The revelations come after a series of scandals in CHI, which is due to run the new national children's hospital when it opens. The Cabinet committee on health was told on Wednesday that the Health Service Executive (HSE) has referred the report to the Garda with a view to it being assessed for a possible investigation. READ MORE The meeting was attended by Taoiseach Micheál Martin , Tánaiste Simon Harris , Minister for Health Jennifer Carroll MacNeill, Minister for Finance Paschal Donohoe, Minister for Public Expenditure Jack Chambers and Minister for Children Norma Foley. [ Audit of CHI waiting lists ordered to ensure productivity in public hospitals, Minister for Health says Opens in new window ] The National Treatment Purchase Fund (NTPF), which buys treatments in the public and private sectors for patients on long waiting lists, has said it will pause funding for CHI while potential irregularities are investigated. Ms Carroll MacNeill has assured parents scheduled surgeries will not be delayed. Earlier this week, The Irish Times reported further findings, including about reports of a 'toxic' work culture in parts of a CHI hospital, where there were complaints of bullying and victimisation of trainees, and where one consultant had taken proceedings for defamation against another. The CHI internal report was drawn up in late 2021/early 2022 but was not given to the then minister for health, the HSE or the NTPF. The report found CHI had a 'broken culture' created by dysfunctional relationships and challenging behaviour. It said there were also concerns about management of NTPF funding and a lack of oversight of access initiatives that ultimately were not in keeping with a memorandum of understanding between CHI and the NTPF. [ CHI consultant at centre of review did not fulfil on-call hours for three years due to 'health issues' Opens in new window ] The report raised concerns about five special weekend out-patient clinics for 179 children carried out by a consultant. These were funded by the NTPF. The consultant received €35,800 for seeing these patients at the special out-patient clinics that operated over five Saturdays. The report questioned whether these clinics were needed and suggested the patients could have been treated by other doctors in the public system. On Tuesday the NTPF suspended payments on a temporary basis pending an investigation into the operation of the waiting list schemes in CHI. According to the report, which CHI said it cannot publish for legal reasons, the consultant was indefinitely removed from on-call duty for 'health reasons' in 2019, a commitment under his public contract. CHI hired a locum to fill these hours, spending about €450,000 on the locum between 2019 and when the review took place in 2021. The report said : 'It needs to be explored how one consultant can undertake a series of NTPF-funded clinics over numerous Saturdays and during these clinics see a much greater number of patients than they are able to see in their routine public clinics, working at a very fast pace with significant throughput – a substantial undertaking of additional work, yet is unfit for any on-call duties for the past three years.' The NTPF-funded clinics were not sought by or offered to any of the other eight general surgeons in CHI, it said . In a statement earlier this week, CHI said the NTPF-funded clinics were a waiting-list initiative and were 'over and above the consultant's contractual hours'.
