Next year must see a “reset” of relations between the State and the country’s voluntary hospitals, which receive several billion euro collectively from the exchequer to treat public patients but are run by their own boards, Minister for Health Jennifer Carroll MacNeill has told the HSE.
The voluntary hospitals and the HSE have clashed in recent months over plans by the health authority to introduce a new €200 million national financial information system. Some hospitals are concerned about the impact the move could have on their independence.
Voluntary hospitals, which include large institutions such as the Mater and St Vincent’s in Dublin, the Mercy in Cork and the main maternity hospitals such as the Rotunda, the Coombe and Holles Street, collectively receive about €5 billion in funding annually from the exchequer through the HSE. Although they have their own boards, their staff are considered to be public service personnel.
In her annual letter to the HSE setting out policy direction, the Minister said voluntary hospitals must put in place all new national technology systems and follow rules set by the Government on pay and spending. The timescale for hospitals to sign their annual agreements with the HSE must also be brought forward to much earlier in the year, the Minister instructed.
READ MORE
“I expect all service arrangements with acute voluntary hospitals [the agreements with the HSE on what will be provided in return for exchequer funding] to be completed and signed no later than February.
“This includes a clear statement in each service arrangement that funded entities will comply with adoption of any mandated systems, for example; IFMS [the financial management system], NiSRP [a national staff records and pay programme] and MedLIS [the medical laboratory information system] and also that they will comply with all public policy controls on use of public funds [pay and non-pay].”
She said the list of projects set out in her letter as examples of those to be implemented was not exhaustive.
The Irish Times reported in November that voluntary hospitals were concerned about the impact the introduction of the HSE financial management system could have on their independence. They had sought changes to reflect the different legal regime under which they operated and the responsibilities of their directors under company law and legislation governing charities.
In September the association representing voluntary hospitals told HSE chief Bernard Gloster that the IFMS reporting system appeared “to envisage a loss of control by boards over various processes that are central to the management of a voluntary hospital”.
Among assurances sought by the hospitals were that their financial decisions could not be vetoed and approval for payments would not be required from the HSE.
However, it is understood Ms Carroll MacNeill told the Cabinet subcommittee on health recently she would write to voluntary hospitals that there were no legal issues for the autonomy of their boards arising from the implementation of the planned new financial management system.
It is understood she said the annual service agreements contained the “contractual” provisions that determined the relationship between the HSE and the voluntary hospitals.
It is understood the Minister also said the implementation of such national systems was required under the service agreements between voluntary hospitals and the HSE.
The Minister is expected to introduce amendments to health legislation at Seanad stage to set out specifically the authority of the HSE to request and receive information from health service providers in the voluntary hospital sector and among other agencies to which it provides State grant funding.
