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Irish Examiner
3 hours ago
- Business
- Irish Examiner
NTPF to face Public Accounts Committee over CHI oversight and funding concerns
The National Treatment Purchase Fund (NTPF) must appear before the Public Accounts Committee (PAC) to answer questions about its oversight arrangements, a PAC member has said. Social Democrats TD Aidan Farrelly has written to the committee's chair, calling for the NTPF to be added to its programme for this term. "The budget of the NTPF has increased exponentially in recent years and now stands at more than €220m this year alone," said Mr Farrelly. "However, recent scandals at Children's Health Ireland (CHI) have raised serious concerns about the NTPF's oversight of the allocation of public money for insourcing treatment." He added that the NTPF's decision to suspend all funding for insourcing at CHI suggests a lack of confidence in existing monitoring systems. While it is welcome that the NTPF has begun reviewing its operations at CHI, The Kildare TD said the results must be brought before PAC and thoroughly examined. "It must also provide assurances that the problems identified in insourcing at CHI are neither replicated across the country nor repeated when it comes to outsourcing treatment." Labour TD Marie Sherlock said she is deeply concerned that what is happening with CHI waiting lists is 'highly likely' to be occurring elsewhere in the health service. "It is abundantly clear that patient safety has taken a backseat across the health service," said Ms Sherlock. "I am deeply concerned that what is happening at CHI represents but a microcosm of the scale of abuses across the health sector. With more questions than answers, we need to hear in detail from the board of CHI, the minister and the CEO of the HSE." Labour TD Marie Sherlock said she is deeply concerned that what is happening with CHI waiting lists is 'highly likely' to be occurring elsewhere in the health service. Picture: SAM BOAL/Collins Photos Referring to the allegations involving an individual consultant, she warned that "the rights of one individual simply cannot trump patient safety". The Labour health spokesperson said extracts of CHI's internal review paint a "damning picture of a broken culture", and urged that the full report be published to provide transparency for affected families. On Wednesday, health minister Jennifer Carroll MacNeill asked parents for patience, saying: 'Sit with me just for a week or 10 days' to allow the NTPF to complete its work. "The NTPF has already assured that existing surgery scheduled will not be impacted but our concern is we need to make sure that this isn't happening anywhere else in the system," she said. Health minister Jennifer Carroll MacNeill asked parents for patience, saying: 'Sit with me just for a week or 10 days' to allow the NTPF to complete its work. Ms Carroll MacNeill also revealed that the NTPF only recently became aware that no referral had been made to the National Patient Safety Office, nor had any notification been sent to the department of health. "Let's not underestimate the impact of that, nor was there a referral to the department or a notification to any of us. So that's not a satisfactory way of managing that, and I expect that to be very, very different," Ms Carroll MacNeill told RTÉ Radio's Morning Ireland. She stressed the need for the NTPF to prevent cases where children wait so long that they end up on the NTPF list unnecessarily, missing earlier opportunities for surgical intervention. "That is the bigger issue and that is what raises such particular concerns around the issues in this report but it also raises the broader patient safety concerns and what we need to do is make sure that that is happening in the most productive way in the public system in every discipline," said Ms Carroll MacNeill. The minister added that, alongside the audit, there will be a move towards a centralised referral system. Under the proposed change, children referred for surgery would be added to a central list rather than being assigned to a specific consultant, improving transparency and equity. Read More Ireland does not satisfy international standard for election observation, group claims
The Journal
5 hours ago
- Business
- The Journal
Health Minister calls for CHI report on consultant misuse of waiting list system to be published
THE HEALTH MINISTER has said she wants an internal investigation which found a consultant had breached guidelines by referring public patients to his own private clinic to be released in the 'public interest'. It follows reports that an internal investigation by Children's Health Ireland (CHI) found that the consultant breached HSE guidelines with these referrals . The consultant was paid €35,800 via the National Treatment Purchase Fund (NTPF), which aims to cut waiting times by paying private practices to treat patients on public waiting lists. While CHI said the 'confidentiality of those who participated' in the internal investigation needs to be respected, Health Minister Jennifer Carroll MacNeill called for a redacted version of the report to be released in the public interest. The Irish Times today reported that the consultant at the centre of the internal CHI investigation didn't fulfil his on-call hours for more than three years due to health issues, yet went 'above and beyond his contractual hours' to conduct weekend clinics. The Irish Times reports that the consultation seen twice the number of patients in the weekend clinic than during his regular weekday equivalent, and received €35,800 for this weekend work. Caroll MacNeill said these reports 'suggests a very significant problem'. She told RTÉ's Morning Ireland that she wants 'maximum productivity' in the public system and wants to 'remove incentives that may create perversions of the kind that's described there'. She added: 'I do not want to see a situation where there is less than full productivity in the public system and then private clinics picking that slack up when insourcing an NTPF model. 'I have a concern that that has led to some incentives to delay treatment, and that is why a number of weeks ago, we commissioned a full audit of that practice right across the board. 'Where we look at this report, that has not been published, my concern for that is the correct use of taxpayer's money, but even more importantly, patient safety and patient outcomes for very young children who needed surgical intervention.' 'Inaccurate reporting' The internal CHI report in question was conducted at the end of 2021 and finalised in January 2022. In a statement on Monday, CHI said the 'recommendations have been implemented and are ongoing'. However, the CHI statement said there has been 'inaccurate media reporting in relation to NTPF payments to a Consultant'. CHI said these 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. Advertisement 'This was over and above the Consultant's contractual hours. There are no direct payments to CHI staff from NTPF.' CHI added that it considered requests to publish the report and sought legal advice. The statement said it is 'primarily a HR report where the confidentiality of those who participated and fair procedures need to be respected given the sensitive nature of the report'. NTPF funding The NTPF aims to cut waiting times by paying private practices to treat patients on public waiting lists. However, NTPF funding to CHI has been suspended and Carroll MacNeill said the NTPF has 'looked for certain assurances from CHI, which I understand they're in the process of receiving'. Carroll MacNeill said she had been assured by the NTPF that the existing surgery scheduled will not be impacted by this. The Health Minister added that she had a 'very good meeting' with the Attorney General last week and she was informed that she does not have a 'legal basis to publish the report' as it is the 'property of CHI'. 'I do recognise some of the difficulties that CHI face in that this was a HR report where people contributed on a confidential basis and put themselves at risk in doing so,' said Carroll MacNeill. 'There's a measure of management, because we do want people to contribute to other HR processes. 'Nevertheless, I think it's important that a redacted version of this report is published in the broader public interest. 'It is important that people understand the broad issues that have happened here and what needs to happen next.' Last month, HSE CEO Bernard Gloster said that the potential for CHI to be fully subsumed into the HSE will be one option considered amid concerns around clinical care and governance. Carroll MacNeill today said this is a 'separate, longer term public policy consideration'. Meanwhile, three board members of CHI resigned last week , and Carroll MacNeill remarked that there has been 'a significant refresh'. 'There are more board vacancies and I think the correct approach to this is to continue to appoint members of the HSE board to CHI board, insofar as that is possible.' And while Carroll MacNeill called on CHI to release a redacted version of the report, she said she has 'confidence' in its chair Lucy Nugent, who was appointed last November and took up the role in February. Carroll MacNeill said Nugent 'has begun a significant program of transformation in a couple of different ways'. 'A lot of these practices predate her, and I want to offer my support to the new CEO.' 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
8 hours ago
- Business
- Irish Times
Audit of CHI waiting lists ordered to ensure productivity in public hospitals, Minister for Health says
Minister for Health Jennifer Carroll MacNeill has said she called for an overall audit of how waiting lists are managed 'across the board in CHI [Children's Health Ireland]' because it is one of her major concerns. 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 since suspended all funding for 'insourcing arrangements' at the children's hospital group. Speaking on RTÉ radio's Morning Ireland, Ms Carroll MacNeill said that as Minister she needed to ensure the public system was working in the most productive way 'during the public hours that consultants are paid to do public work in a public hospital'. READ MORE 'What's not acceptable and what the concern is here is that those procedures are not happening quickly enough or in [an efficient] way and that they're becoming such long waiters that NTPF intervention is required,' Ms Carroll MacNeill said. ' Bernard Gloster and I have decided to have an overall audit of how are these waiting lists managed generally across the board in CHI in every discipline to ensure that that's not being replicated.' The Minister continued: 'This is something where the NTPF absolutely need assurance that this is being done correctly, but what they also need is to make sure that there is no mismanagement of lists, such that a child is waiting so long that they are required to be on the NTPF list where there could have been an earlier surgical intervention. The Minister said that there would also be a change whereby if a child was referred to a consultant surgeon, they would not be referred to an individual surgeon, but into a central referral mechanism. 'Which means that the hospital can assess who has the shortest list, who has capacity to do this, rather than being sort of assigned to or stuck with an individual, who then has the capacity to do things at whatever pace,' Ms Carroll MacNeill said, adding that some work 'very efficiently, and others less so'. [ Revelations show appalling personal behaviour among some CHI medics Opens in new window ] The Minister said that she, along with the NTPF, Bernard Gloucester and CHI, need to make sure there are 'no perverse practices or no perverse incentives from the way in which waiting lists are managed'. 'So I would ask parents to just sit with me, just for a week or 10 days, to allow the NTPF to get these assurances and to do their work,' Ms Carroll MacNeill said. 'The NTPF have already assured that existing surgery scheduled will not be impacted, but our concern is we need to make sure that this isn't happening anywhere else in the system.' Ms Carroll MacNeill acknowledged that the NTPF only recently discovered that there had not been a referral to the National Patient Safety Office. 'Let's not underestimate the impact of that, nor was there a referral to the department or a notification to any of us. So that's not a satisfactory way of managing that, and I expect that to be very, very different,' she said. 'There is no CHI without the State. The State is the funder of all of these services... everybody who is in CHI is a public servant, and it is important that they understand that.'
BreakingNews.ie
9 hours ago
- General
- BreakingNews.ie
CHI audit finds paediatric critical care units 'under strain'
An audit of the country's two paediatric critical care units, at Crumlin and Temple Street, has found that while they deliver high-quality care, the system is under strain. The number of children admitted to adult intensive care units doubled to 148 cases in 2023. Advertisement The National Office of Clinical Audit found high bed occupancy rates, that were above 95 per cent, and says more investment is needed. The Minister for Health Jennifer Carroll MacNeill has said that one of her major concerns is how waiting lists are managed which was why she had called for an overall audit of how waiting lists are managed 'across the board in CHI'. Speaking on RTÉ radio's Morning Ireland, Ms Carroll MacNeill said that as Minister she needed to ensure that the public system was working in the most productive way 'during the public hours that consultants are paid to do public work in a public hospital. 'What's not acceptable and what the concern is here is that those procedures are not happening quickly enough or in a sufficiently efficient way and that they're becoming such long waiters that NTPF intervention is required. Advertisement 'So my underlying issue is, how are those lists being managed? So what I've done is, Bernard Gloster and I have decided to have an overall audit of how are these waiting lists managed generally across the board in CHI in every discipline to ensure that that's not being replicated.' Ms Carroll MacNeill urged concerned parents to 'just sit with me and sit with the NTPF for a number of days, for a week or 10 days to allow the NTPF to do their work". 'This is something where the NTPF absolutely need assurance that this is being done correctly but what they also need is to make sure that there is no mismanagement of lists such that a child is waiting so long that they are required to be on the NTPF list where there could have been an earlier surgical intervention. 'And that is the bigger issue here. That is the bigger issue and that is what raises such particular concerns around the issues in this report but it also raises the broader patient safety concerns and what we need to do is make sure that that is happening in the most productive way in the public system in every discipline.' Advertisement The Minister said that in addition to the audit there would be a change to a centralised referral mechanism which would mean that if a child was referred to a consultant surgeon, they would not be referred to an individual surgeon, but into a central referral mechanism. 'Which means that the hospital can assess who has the shortest list, who has capacity to do this, rather than being sort of assigned to or stuck with an individual, who then has the capacity to do things at whatever pace, and some of them are doing very efficiently, and others less so.' 'We need to make sure and the NTPF need to make sure, and I need to make sure, Bernard Gloucester needs to and the CHI need to make sure that there are no perverse practices or no perverse incentives from the way in which waiting lists are managed. 'So I would ask parents to just sit with me just for a week or 10 days to allow the NTPF to get these assurances and to do their work. The NTPF have already assured that existing surgery scheduled will not be impacted but our concern is we need to make sure that this isn't happening anywhere else in the system.' Advertisement Ms Carroll MacNeill acknowledged that the NTPF had only recently discovered that there had not been a referral to the National Patient Safety Office. 'Let's not underestimate the impact of that, nor was there a referral to the department or a notification to any of us. So that's not a satisfactory way of managing that, and I expect that to be very, very different. There is no CHI without the state. The state is the funder of all of these services, and people who work in CHI, both at executive level, but let me be very clear, consultants in CH , and everybody who is in CHI is a public servant, and it is important that they understand that.'
Irish Times
12 hours ago
- Business
- Irish Times
CHI consultant at centre of review did not fulfil on-call hours for three years due to ‘health issues'
A consultant working at Children's Health Ireland (CHI) who was at the centre of an internal review for allegedly referring patients to a weekend clinic did not fulfil his on-call hours for more than three years due to 'health issues', a confidential report has found. However, during this period, the doctor went 'above and beyond his contractual hours' to conduct weekend clinics designed to reduce waiting lists and for which he received additional money. An internal CHI review from 2021-2022 highlighted how one consultant was allegedly referring patients to public weekend clinics at the hospital that were funded by the National Treatment Purchase Fund (NTPF) in a bid to tackle waiting lists. This consultant was seeing twice the number of patients in the weekend clinic than during his regular weekday equivalent, the review said. He received €35,800 for the weekend work, it added. READ MORE 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 around €450,000 on the locum between 2019 and when the review took place in 2021. The report stated: '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 or offered to any of the other eight general surgeons in CHI, it added. In a statement, CHI said the NTPF-funded clinics were a waiting-list initiative and were 'over and above the consultant's contractual hours'. According to the report, the findings 'strongly suggest' patients were placed on waiting lists, despite other general consultants being available 'for quicker treatment and care'. Some patients requiring surgery were waiting 'far in excess of the recommended timeline for treatment', the report added, which placed the children 'at real and known risk for fertility issues and or cancer in later life'. The report recommended all consultants identified as facilitating 'inequitable and unfair' distribution of referrals 'should be held to account'. It added that consideration should be given for a referral to the Irish Medical Council or other relevant body. The consultant did not face disciplinary action, nor was he referred to the medical council. He retired following the report. The practices identified in the audit were 'not in the best interest of the child', the report said, adding that CHI has a 'broken culture' which 'has the potential to put patients at risk'. 'CHI, and indeed the HSE, cannot and will not stand over behaviour or practice which undermines the integrity of public organisations,' the review said. The NTPF has, meanwhile, suspended all funding for in-sourcing arrangements at the children's hospital group on foot of concerns raised about how such schemes have been operated in the past. In-sourcing 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 provide treatment to those waiting longest for care. The NTPF receives over €200 million each year to buy treatment in the public and private systems for patients on long waiting lists for treatment. Taoiseach Micheál Martin said on Tuesday that the 'essence' of the internal report, which also covered negative and toxic work culture at a hospital run by CHI, should be made public. In a statement, a spokeswoman for CHI said recommendations from the review 'have been implemented and are ongoing'. 'Work on CHI's culture is ongoing, as should be expected when you look at international examples of transformation programmes of this nature.'
