Latest news with #NationalTreatmentPurchaseFund
Irish Examiner
17 hours ago
- Health
- Irish Examiner
CHI failure to deliver international best practice 'harmed' children, among findings of report
The unpublished report, seen by the Irish Examiner, into concerns at Children's Health Ireland hospital identified: • An unknown number of children — between five and 80 — with the same health condition receive 'suboptimal' care at this hospital compared to how patients with the same condition are treated in another CHI hospital. They were known as 'orphans' internally, with one staff member interviewed saying: 'How can you have patients that aren't someone's responsibility?' • Some of the children may develop cancer or be infertile due to delays related to a procedure which should be done by 18 months old. • The review quotes another unpublished report from 2017, which warned of similar problems for these patients. It says by 2021 they found 'lack of clarity' about actions taken on that older report. • National Treatment Purchase Fund monies given for 'insourcing' to run extra clinics for 179 children is questioned. Some 95% of children seen could have been seen in another service during regular hours without extra funding. Some could have been seen sooner. Some of the children were referred to an inpatient waiting list which was longer than at another service which could have treated them. The review found this was 'potentially negligent'. • Risk assessment in 2021 for one national service said children being treated 'have a poor experience or are harmed due to the inability of CHI to deliver international best practice standards of [this care]'. It was given a risk score of 20 out of 25 • A 'toxic culture' was identified, with three specialist nurses leaving one service between 2013 and 2021. Comments show one person had panic attacks at work. Trainee doctors faced a 'psychologically unsafe environment' in one department reviewed. • Some 89% of people interviewed described 'a culture where change was slow, which lacked governance and robust processes' across CHI as a whole, while 43% said 'they wanted to see real change across CHI'. • A defamation case is on-going between two consultants, which the report linked to 'fraught relationships' between two services in which they work.
Extra.ie
2 days ago
- Health
- Extra.ie
Teen cancer patient among those 'harmed by NTPF abuse'
The lives of seriously ill patients – including a teenager with cancer – were put at unnecessary risk due to alleged abuses of the National Treatment Purchase Fund (NTPF), a whistleblower has claimed in a protected disclosure. They also accuse Health Service Executive (HSE) chief Bernard Gloster of failing to fully investigate serious allegations of NTPF abuses highlighted in a series of emails sent to management between 2022 and 2023. This comes as a Cabinet source who has read the unpublished Children's Health Ireland (CHI) report says any informed reader of it would immediately fear the spectre of widespread abuse of the NPTF system, saying: 'If it could happen in that list, how do we know it didn't happen in other parts of the health service?' In the protected disclosure to the HSE whistleblower detailed a series of alleged 'wrongdoings' arising out of the replacement of existing scanning services to public patients at a hospital with a significantly more expensive NTPF service. Health Service Executive (HSE) chief Bernard Gloster. Pic: Gareth Chaney/Collins Photos They also provided details of a list given to the head of the health service of dozens of patients whose diagnosis and treatment were allegedly delayed so work could be done instead by consultants paid through the more lucrative NTPF scheme. Some of these include children suffering from life-threatening illnesses. The whistleblower this weekend claimed the 'problem has not been resolved and is still happening to this day', forcing patients 'with suspected cancer to go privately to get their scans done promptly'. Despite the serious nature of the allegations, the whistleblower said a series of emails sent between 2022-2023 to Mr Gloster and other HSE bosses received 'no meaningful response'. The latest revelations come as it emerged on Thursday that the damning internal report on the use of public funding for waiting lists at a children's hospital has been referred to the gardaí by the HSE. In a recent RTÉ interview, Mr Gloster vowed to report any misuse of public funds to gardaí. Asked if Mr Gloster reported the concerns of the HSE whistleblower to gardaí, a ,spokeswoman said: 'The CEO office receives a high volume of correspondence all of which is appropriately referred for appropriate attention to relevant parts of the organisation.' In their protected disclosure, the whistleblower claims: HSE management failed to investigate why dozens of patients had their diagnosis and treatment delayed because the processing of scans at a public hospital was diverted to the NTPF scheme n Despite receiving a detailed list of these patients, Mr Gloster merely passed on the infordone promptly'. Despite the serious nature of the allegations, the whistleblower said a series of emails sent between 2022-2023 to Mr Gloster and other HSE bosses received 'no meaningful response'. The latest revelations come as it emerged on Thursday that the damning internal report on the use of public funding for waiting lists at a children's hospital has been referred to the gardaí by the HSE. In a recent RTÉ interview, Mr Gloster vowed to report any misuse of public funds to gardaí. Asked if Mr Gloster reported the concerns of the HSE whistleblower to gardaí, a HSE spokeswoman said: 'The CEO office receives a high volume of correspondence all of which is appropriately referred for appropriate attention to relevant parts of the organisation.' In their protected disclosure, the whistleblower claims: HSE management failed to investigate why dozens of patients had their diagnosis and treatment delayed because the processing of scans at a public hospital was diverted to the NTPF scheme. Despite receiving a detailed list of these patients, Mr Gloster merely passed on the information to another HSE official, and that 'no feedback' was received and 'no solution' was proposed. Hospital management 'actively blocked' HSE staff from using rooms and equipment, which resulted in 'artificially' created waiting lists which were then referred to a more expensive NTPF-funded service. Some consultants employed under the NTPF are working simultaneously at multiple hospitals by allegedly subcontracting work out to other medics. Hospitals are powerless to hold some consultants working under the NTPF accountable for errors because they are not members of staff, but are instead paid through a network of corporate entities or sole trader firms. The standard of some work done under the NTPF is so poor it has resulted in patients being unnecessarily subjected to tests and invasive biopsies Some consultants are blocking colleagues from treating public patients so that they can profit from the human misery of people on lengthy waiting lists. The whistleblower described how a more expensive NTPF system was introduced at a public hospital to replace a 'normal scanning process' that had successfully worked through waiting lists. They told : 'Prior to the NTPF, patients were scanned depending on their need and there was no waiting list. But when the NTPF was introduced, patients had no option but to either wait and go on the NTPF list or else go elsewhere for their scans. 'Either way, there was a delay in their treatment,' they said. 'The people who went to get scans done privately suffered further delays because their images were not made available on the hospital system, so they had either to wait to be rescanned through the NTPF process or go elsewhere for their treatment. 'One of those affected by the delays in treatment was a teenager with cancer.' The latest damning allegations emerged as the NTPF this week suspended funding to the CHI group pending the outcome of 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. Pic: Getty Images These include payments made to a consultant to treat patients at a weekend clinic in a public hospital. The consultant was reportedly already earning in the region of €250,000 a year but was not available to work 'on call' for health reasons. However, he was still paid €35,800 extra under the NTPF to treat patients at the weekend clinic. According to an unpublished internal CHI report, the consultant breached both HSE and NTPF rules. It is alleged that he failed to check if any of his colleagues could see his patients who were left languishing on waiting lists. As a result, some patients were able to jump ahead of those with more urgent health needs, while others were selected ahead of those waiting longer for care. The consultant has since retired, and it is unclear if any disciplinary action was taken against him. Health Minister Jennifer Carroll McNeill has ordered Mr Gloster to carry out a full audit of the governance and practices of CHI. The HSE yesterday said 'the audit terms and plan are being finalised in the coming days'. While the CHI has been the focus of recent coverage about alleged NTPF abuses, the whistleblower's warnings to HSE management as far back as three years ago indicates the problem extends beyond a single consultant working at a children's hospital. A minister last night expressed fears there could be more widespread abuses of the NTPF. They told 'Rarely are these things confined to one waiting list. I have the benefit of having read the [internal Children's Health Ireland] report that's not yet published, into the urology stuff, but, a lot of it's out there. 'It's bad, right, to put it mildly, but, but anybody who reads, this will think: 'Hang on a second – if it could happen in that list, how do we know it didn't happen in other parts of the health service?' Jennifer Carroll MacNeill. Pic: Gareth Chaney/Collins Photos 'And, of course, the Department of Health is endeavouring to discover how widespread the practice is.' The Cabinet source added: 'In fairness to the NTPF they have very strong rules around what it can and can't be used for. But the questions are: were those rules followed in hospitals, and secondly, did the NTPF do their job at making sure the rules are applied? And I don't know the answer to those questions, though it sounds like the protected disclosure your organisation has seen may give very concerning answers to those questions. 'I repeat, it's rarely ever confined to one doctor or one list.' The NTPF will receive about €230m from the exchequer this year to buy treatment in both the public and private systems for patients on waiting lists. Around €70m a year is also allocated to hospitals to pay staff overtime to work their way through waiting lists in schemes known as 'blitzes' by healthcare professionals. The NTPF declined to comment on the whistleblower's allegations that the taxpayer-funded scheme is being abused at a public hospital. In response to queries, a HSE spokesperson said: 'On the wider issue of waiting list-funded initiatives, the CEO initiated and subsequently published a 2023 and 2024 internal audit on a range of these matters, indicative of his concern regarding the fine balance between privately-funded initiatives to reduce waiting lists and the need for probity. 'He has commenced a nationwide survey and review of insourcing, a methodology used in such initiatives, and has taken certain precautionary steps in the interim to further reduce the risks of conflicts of interest and other concerns that might arise. This remains a work in progress.'
RTÉ News
5 days ago
- Health
- RTÉ News
HSE intends to meet gardaí to discuss internal CHI report
The HSE has said it has decided to refer matters raised in the internal Children's Health Ireland report to An Garda Síochana and intends to meet gardaí very shortly to discuss it. The HSE said it has also decided that matters raised in the report will be referred to the Medical Council and it will discuss with CHI how this will be done. The Medical Council is the policing body for doctors' behaviour. Once the report has been received, gardaí will assess whether an investigation should be commenced and, ultimately, if a report should be sent to the Director of Public Prosecutions. The unpublished report has caused shock in Government circles, with Taoiseach Mícheál Martin saying yesterday that the "essence" of the report should be made public given the disquiet it has triggered. The report, which has been seen by RTÉ News, concluded that "a root and branch review" of use of the National Treatment Purchase Fund and other waiting list initiatives "should be undertaken". It also said "the longest waiters were not seen at NTPF clinics" and that "45 children who required surgery did not receive a date for same and instead were placed back on one consultant's inpatient waiting list which has a significant wait time". The report was first referenced by the Sunday Times last month, when it reported that a consultant who has since retired had breached guidelines by referring public patients to the doctor's own weekend clinics.
