The Rotunda Hospital has received additional funding from the Health Service Executive to resolve a dispute over staffing and resources that had left it with a projected €6 million deficit.
The move came after the hospital’s board warned it was being penalised for increasing activity and treating more women.
The hospital’s governors believed HSE financial and staffing restrictions had had “a significant adverse impact” and were concerned at the potential effect on its “ability to meet its current service demand while ensuring a safe and quality service”.
Hospital authorities escalated their concerns directly to HSE chairman Ciarán Devane last December.
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The hospital said it delivered about 1,700 more babies than the other Dublin maternity centres, the Coombe and the National Maternity Hospital, but these received more money “ranging from €1 million – €8 million, despite significantly less activity”.
The Rotunda receives just over €100 million in annual State funding.
The master of the Rotunda, Prof Seán Daly, told The Irish Times this week that it had further engagement with the HSE and subsequently received additional support, in tranches, to deal with the projected €6 million shortfall and allow it to come in on balance for the year.
The Rotunda, like other voluntary hospitals, operates under a service agreement with the HSE.
However, in a letter to Mr Devane, Rotunda chairman Prof Tom Matthews said “given the proposed financial limit for the hospital, it is difficult to understand how anyone, in good faith, can sign an agreement that is clearly incorrect”.
Prof Matthews said the Rotunda was the busiest maternity hospital in Ireland and northern Europe. He said the number of babies delivered had continued to increase, to 8,600, when numbers were falling in all 18 other maternity units in the country.
“In addition our gynaecology service has had an unprecedented increase in demand and our gynaecology activity, both outpatient consultations and inpatient management, has increased by almost 30 per cent when compared to 2023.
“At the end of July [2024] the HSE unilaterally, and without any direct engagement with the hospital, imposed a budgetary financial limit and a workforce headcount limit on the Rotunda Hospital. This arbitrarily imposed financial limit has had a significant adverse impact on the Rotunda and resulted in a projected financial shortfall of €6 million in 2024.”
Prof Matthews said there were errors in the HSE’s position including “in the requirement to reduce overtime by €2 million”.
He said historically hospitals providing the most activity had effectively received a budget boost. He said in 2023 the Rotunda received an additional €1.1 million but under the financial limits for 2024 this was excluded.
Prof Matthews said “hospitals, such as the Rotunda, which have increased activity and cared for more women in 2024 than in 2023 are ultimately being penalised for these service initiatives and the principle of funding following or reflecting activity has simply not occurred”.
