Latest news with #waitinglists
Irish Times
15 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.'
Irish Times
20 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.'
BBC News
3 days ago
- Business
- BBC News
Northern Ireland waiting lists: Cross-border operations money-back scheme starts
People who have been on an NHS waiting list for more than two years will now be able to pay for procedures in the Republic of Ireland and claim money £10m cross-border plan, designed to tackle waiting lists, came into effect on Monday Department of Health (DoH) said that, in future, patients would be able to claim back money for operations in the rest of the a date has yet to be set for when that extension will happen, and the number of patients able to avail of it will depend on how much money is left from the cross-border scheme. "The second phase of the scheme – extension to the rest of the EU – will go ahead," a DoH spokesperson said."The scale of available funding will clearly be connected to take-up levels for the first phase." Budget The department is already facing a £600m deficit in its budget as it struggles to reduce waiting lists and fund pay increases for healthcare reimbursement scheme was one of several initiatives Health Minister Mike Nesbitt announced to tackle waiting lists for planned operations, which are the highest in the cross-border element of the scheme means patients will get back the amount of money the operation would have cost in Northern Ireland, subject to it was launched last month, the department said full details of the plan were yet to be outlined and the full range of eligible procedures covered by the cross-border scheme was not known. Online information hub Those eligible for the scheme will be able to access a Health and Social Care online information hub giving guidance to patients on how to apply, eligibility criteria and access to the application reimbursement scheme was included in a plan outlining how £215m was to be used to tackle Northern Ireland's spiralling hospital waiting that, there will be £85m for red flag and critical care, £80m for building up capacity within the system, and up to £50m to start tackling the backlog in plan is to clear the four year waits for more than 3,000 patients on lists for hip, knee, hernia and colonoscopy will be mega clinics for an estimated 20,000 patients waiting for ophthalmology, orthopaedics, general surgery and ear, nose and throat (ENT) lists for gynae mesh, children's squints, children's feeding tubes and cleft lip will also be department said there will also be a boost in the number of urology specialist nurses and an expansion of rapid diagnosis centres for quicker detection of pancreatic cancer.
Irish Times
3 days ago
- Business
- Irish Times
Fund set up by Micheál Martin 20 years ago to cut hospital waiting lists under fresh scrutiny
In February, Jennifer Carroll MacNeill became the latest Minister for Health to announce a new initiative to reduce the amount of time patients have to wait for treatment in public hospitals . The Irish health system has been struggling for years to deal with growing waiting lists with bed and staffing capacity lagging behind demand. The answer for successive governments has been to either use the private sector or to get existing personnel to do more in their own time, while the Health Service Executive moved to increase its own resources. The amount of money allocated to these initiatives has been staggering. The Minister's plan in February involved a €420 million investment, including €190 million for the HSE and €230 million for the National Treatment Purchase Fund (NTPF) – the organisation established by Micheál Martin 20 years ago to buy treatment for public patients. READ MORE Between 2022 and 2024 under Stephen Donnelly , about €1.23 billion was allocated to the HSE and the NTPF. Government funding was essentially spent in three ways. First, it allowed the HSE to appoint more staff to increase its own capacity. Second, it allowed the NTPF to buy care in private facilities. Third, it allowed for what is known as 'insourcing', where health service personnel are paid by the NTPF or other entities to provide treatment outside normal hours in public hospitals for those on waiting lists. A recent internal report carried out by children's healthcare group CHI , has led to more intense scrutiny of the various waiting list initiatives. The report alleged that a doctor had delayed operations on children before eventually they were treated at weekend clinics that he was operating separately. In the Dáil, the Taoiseach said the CHI report 'makes for shocking reading of the most profound kind, which not just goes to the heart of the misuse of NTPF funding but more seriously raises fundamental concerns at that time about safety for children receiving surgery'. Cian O'Callaghan of the Social Democrats told the Dáil that the report found the consultant earned more than €35,000 by keeping very young children on a waiting list for years. 'They were eventually treated using the NTPF when they were transferred to the consultant's weekend clinic, but they could have been treated by other doctors years earlier. When all of this was discovered, it was kept a secret and the consultant was allowed to retire and sail into the sunset.' The Minister and HSE chief Bernard Gloster had been kept in the dark about the report but were given copies last week. There have been other controversies surrounding waiting list funding. On April 18th, Mr Gloster directed his senior leadership team to halt, for the present at least, aspects of the 'insourcing' arrangements. He commissioned a survey to establish the dependency of the health system on such practices and to ensure 'there were no unintended consequences'. Mr Gloster suspended insourcing where staff were 'engaged, hired or paid' by separate entities on initiatives in their area of work. Insourcing was only permitted in cases where the HSE directly engaged its own staff through payroll. His instructions followed discussions with Ms Carroll MacNeill and followed an internal audit report, details of which were revealed in The Irish Times last September. The HSE internal audit found two companies which received more than €1.5 million between them in contracts awarded by University Hospital Limerick without a competitive procurement process were owned or part-owned by employees at the facility. A third company, which received a contract of nearly €400,000, had a HSE employee at a different hospital as a director. Auditors stated €14.2 million was paid out to third-party providers by University Hospital Limerick in 2023 under the Government waiting list initiative without an open procurement process. Auditors said there was no evidence of the HSE employees being involved in the awarding of the contracts. In May, Aontú leader Peadar Tóibín told the Dáil in one case a consultant created a firm to read scans and 'used the hospital public waiting lists to then funnel work through rostering into his own private company'. The NTPF said it was deeply concerned at the CHI internal report. It said it had never received any complaints about hospitals or doctors. Last year, the fund paid €155 million to private hospitals and about €80 million to public facilities. It seeks private hospitals to tender for packages of care and it then attempts to match this capacity with those waiting longest in public facilities. Sara Burke, associate professor of health policy at Trinity College, said the NTPF and the various waiting list initiatives were initially established more than 20 years ago as temporary measures while the State built up its own public capacity. They had, however, become permanent, integral parts of the system, she said. 'Given the amounts of money now being allocated, there is a need to look at how transparent the arrangements are and the governance of these schemes,' she said. The Opposition is now calling for reforms. David Cullinane of Sinn Féin said there were concerns about potential conflicts of interest and called for a centralised system which would see patients referred to a hospital rather than an individual consultant. 'We have to ask genuine questions about what work some consultants are doing from Monday to Friday to carry out public procedures. We need to contrast that with the so-called blitzes and private clinics they are organising and running, while charging €200 for each client they see and making very handsome amounts of money.' Marie Sherlock of the Labour Party said she was uncomfortable about how the current arrangements had grown, the dependency on it that had developed and 'the ability of the public system to wean itself off it'. Mr Tóibín questioned the safeguards in place against conflicts of interest. 'Last year 80,000 public patients were treated in private hospitals at a cost of €100 million. The majority of these treatments should have been done in the public system.' Ms Carroll MacNeill told the Dáil she would be taking further steps to remove the anomalies, which she said existed 'because of the overhanging mix of public and private activity'.
Yahoo
6 days ago
- Business
- Yahoo
More funding 'unlikely' for mental health trust
Health bosses at an NHS trust say they are unlikely to get "significant increases" in funding to tackle growing waiting lists. The Cambridgeshire and Peterborough NHS Foundation Trust's (CPFT) board of directors heard this week that there were "significant waiting lists" of ADHD and autism referrals. As of 8 April, there were 9,757 patients on the ADHD and autism waiting list, with a mean average wait of 92 weeks, the trust's board of directors heard. Dr Mike Knapton, non-executive director and quality and safety committee chair, said the trust took waiting lists "very seriously" and said there are "a number of pieces of work" looking at addressing the situation. The CPFT delivers many NHS services that are provided in the community, including physical and mental health, and specialist services. The trust also runs the Cavell Centre in Peterborough, and Fulbourn Hospital in Cambridge. In December, the NHS trust was rated as "requires improvement" for its mental health services for adults of working age. It said at the time that it took the findings of the Care Quality Commission (CQC) "very seriously". The trust's overall rating with the CQC was "good". The report said the ADHD service "continues to be extremely pressured" and that there was "inadequate resource for the demand". Holly Sutherland, chief operating officer, said given the context of NHS finances the trust is "unlikely to get significant increases in funding" to address the increasing demand for services. She said the trust was looking at how it could "transform delivery" to be efficient and get to those who were most in need. Eileen Milner, chair at the trust, said there had been "exceptional growth" in referrals for autism and ADHD. She added that it was a national issue and told the board that she had recently met with chairs at other NHS Trusts, who had shared that they are experiencing the same increases in demand for services. Ms Milner said they heard from a NHS England representative at this meeting, but said she did not believe a national strategy to address the issue was well developed at this stage. Follow Peterborough news on BBC Sounds, Facebook, Instagram and X. Mental health waiting lists 'grow considerably' Mental health crisis service needs improvement Health bosses concerned over mental health delays Cambridgeshire and Peterborough NHS Foundation Trust
