Hospitals face funding cuts as major government policy change fails – The Irish Times

The Government will stop state funding for new consultant posts in hospitals that cannot demonstrate that their current specialists are seeing the same number of outpatients as their colleagues elsewhere.

In a significant policy change, increasing the number of newly referred patients seen in outpatient clinics, as well as implementing other reforms at individual hospitals, will also become a “significant factor in how funding is allocated/prioritised in the 2025 budget”.

In May, there were more than 593,000 people on waiting lists for outpatient appointments.

Health Minister Stephen Donnelly says some hospitals have been “simply too slow” to implement reforms and efficiency measures that could reduce the number, such as allowing patients to initiate follow-up appointments, and introducing centralised referral systems and text message reminders.

He said implementing such measures, as well as improving the ratio of new to returning outpatients, would have a significant impact on setting hospital budgets next year.

Mr Donnelly told HSE chairman Ciarán Devane that new research revealed “glaring differences” in the number of outpatients seen by consultants from the same speciality in different hospitals, although he added that in some cases such differences may have legitimate reasons.

He also expressed concern about the decline in outpatient numbers in some hospitals.

Mr Donnelly also asked the HSE to pay more attention to people waiting for their first appointment with a specialist at an outpatient clinic.

He added that in the agreement with the government on the national service plan, the Health Service Executive committed to ensuring that for every two new patients admitted for a subsequent visit, one new patient would be seen.

“The HSE is not meeting this target. This needs to be met to ensure more new patients are treated,” the minister told the HSE chairman in a letter in late May that was circulated across parts of the health system.

Separately, the minister told the Health Service Executive that he wanted each of the 2,000 specialist doctors who have signed a new contract with the state to provide public-only care to patients to run “one additional outpatient clinic per week, particularly for new patients on waiting lists”.

The Minister’s decision to link funding for new consultant positions to hospital work productivity from next year would constitute a significant change in policy.

But he added that “it is absolutely vital that we push the system to provide better access for patients, through improved productivity, coupled with increased funding.”

The new system, known as the Healthcare Performance Visualization Platform (HPVP), will enable the Health Directorate to publish data on hospital activity, including “outpatient productivity by facility and specialty.”

This data is expected to be made public in the coming days.

Mr Donnelly told Mr Devane that the importance of benchmarking data was to “identify areas for analysis and improvement”. He said it would then be the responsibility of local management/leaders to “identify the root cause and fix it”.

Mr Donnelly said the 2025 budget would prioritise new consultant posts in large hospitals where the new HPVP system was being used to demonstrate activity and where consultants were providing a similar number of outpatient appointments to their colleagues in other hospitals.