Hospitals fined €1.7m in September over wait time failures

Hospitals were fined €1.7 million by the Health Service Executive (HSE) in September for failing to meet strict targets on cutting waiting times for medical procedures.

New penalties have been imposed from September as part of attempts by Minister for Health Leo Varadkar to set maximum waiting times of 18 months for inpatient and outpatient appointments by the end of June. That figure was to fall to 15 months by the end of the year.

The latest monthly performance report for September, published by the HSE on Thursday, shows that 2,244 patients were waiting longer than 18 months for inpatient and day procedures, while 5,442 were waiting more than 15 months.

Accordingly, financial penalties imposed for the month amounted to €1.68 million.

Mr Varadkar recently released an additional €25 million to help cut waiting times on top of a previous sum of €26 million.

Fines are based on the cost of procedures and number of appointments and the money received will be redirected toward other hospitals and clinics better placed to perform the procedures.

Delays affecting outpatients in September showed 13,176 of them waiting more than 18 months for an appointment and 34,263 waiting more than 15 months.

‘Marginal changes’

Commenting on the ongoing problem, Mr Varadkar said waiting lists were “static with marginal changes in most categories”.

Elsewhere, emergency departments continued to be “extremely busy” in September with almost 6,600 more people seeking treatment than last year.

The HSE reported 3,688 people waited longer than 24 hours to be processed (up from 3,330 in August), of which 864 were aged 75 or more.

Delayed discharges for the month stood at 609, an increase on the previous month’s total of 577.

In budgetary terms the health service is now running a deficit of €385.4 million, having spent, to September, €9.4 billion against a budget of €9 billion.

Significant deficits are anticipated by the end of the year in pensions, standing at €21.3 million by the end of September, representing “retirements in excess of profiled expectations and an increase in the full year pensioner payroll costs”.

On general financial reflection, the review notes sustained pressure in acute hospitals caused by efforts to cope with emergency department delays, people waiting on trolleys, delayed discharges and “excessive waiting lists on the scheduled care side”.

Staffing difficulties

“Difficulties in sourcing medical and nursing staff and the knock-on impacts of risk-related reports such as that into maternity services at Portlaoise have driven strong upward staffing level and pay cost pressures for some hospitals,” it said.

“Within social care the exceptional level of unfunded additional costs arising out of Hiqa inspections of residential facilities continues to contribute to the increasing variance within disability services.”

Mr Varadkar also commented on a “slight deterioration in ambulance turnaround times”.

The report showed calls for life-threatening cardiac and respiratory cases increased by 7 per cent, with 76 per cent of ambulances responding within the 18 minutes and 59 second target time. Calls for other life-threatening emergencies were up by the same percentage, with a 67 per cent response time compliance rate.

No ‘quick fix’

There is no “simple or quick fix solution’’ to problems in hospital emergency departments, Minister for Health Leo Varadkar told the Seanad.

“They all need to be addressed and any efforts and actions must be sustained,” he said.

He had convened the Emergency Department Taskforce last year to provide focus and momentum to deal with the challenges involved, he added.

Mr Varadkar said he wanted to acknowledge that too many patients across Ireland were still spending far too long in emergency departments, waiting to be seen, admitted or sent home.

“This causes difficulties and distress for patients and families and makes working conditions more difficult for staff,” he added. “That is why dealing with the problem is a key objective for the Government.”

Mr Varadkar said the Government had allocated more than €117 million in additional funding this year to reduce overcrowding, while the Fair Deal waiting time was down to between three and four weeks, thus freeing up hospital beds.

A total of 197 hospital beds had been opened nationally since October, with another 44 due to open in the next two weeks.

There were 750 more nurses working in the health service than a year ago and more registered doctors than ever, with a further 338 non-consultant hospital doctors and 78 consultants appointed this year, he added.