Hospitals facing heavy fines for failing to cut waiting lists

Penalties for non-performing hospitals expected to run into millions of euro

Leo Varadkar is releasing €25m to the HSE to tackle hospital waiting times. Photograph: Getty Images
Leo Varadkar is releasing €25m to the HSE to tackle hospital waiting times. Photograph: Getty Images

Heavy fines are to be imposed from this month on low-performing hospitals that fail to meet Minister for Health Leo Varadkar’s targets for cutting waiting lists.

The fines are being levied in respect of almost 8,000 patients who were on waiting lists for over 18 months in August.

Mr Varadkar had previously promised there would be such no long-term waiters from the middle of this year.

As part of a carrot-and-stick approach, the Minister is also releasing €25 million to the HSE so that hospitals can meet his second target of nobody waiting for more than 15 months for appointments or treatment by the end of the year. This is in addition to the €26 million already provided this year to fund the 18-month target.

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The level of fines to be imposed is currently being calculated based on the cost of the procedures and appointments involved, but are expected to run into millions of euro.

The money involved will be diverted from non-performing hospitals to other hospitals or clinics where the work can be performed.

Outsourcing

Exceptions will be made for a small number of specialities where the targets could not be met because of a shortage of specialist staff or pre- and post-surgical supports.

Alternatives such as outsourcing to the private sector will be used in these cases.

Among the hospitals likely to be fined are Galway University Hospital, where 2,320 patients are waiting over 18 months, and Tallaght and Cork University hospitals, with 1,000 long-term waiters each. The mechanism for sanctioning hospitals that fail to meet targets was devised during discussions between the HSE and the Department of Health over the summer.

It is intended the fines will continue to be levied on a monthly basis until hospitals reach the targets set by the Minister.

Started to rise

The number of long waiters has started to rise again since the Minister’s target date of last June. Figures published by

The Irish Times

last weekend showed the number of patients waiting over 18 months for an outpatient appointment was up 465 per cent, while the number waiting for inpatient procedures soared by 7,100 per cent.

The fines are being put in place to stop the figures from slipping back.

In September, fines will be imposed in respect of 6,800 outpatients and 1,000 inpatients still on the list after 18 months. Fines are not being imposed where appointments have been made.

Specific action plans are being put in place for some procedures, such as removal of wisdom teeth, varicose veins, urology and some spinal surgeries. Eleven additional scoliosis patients will have been treated by the end of this month in the Blackrock Clinic and another 56 will be treated in Dublin or London by the end of the year.

Hospitals have been told to carry out urgent colonoscopies within the target time of four weeks, with a zero tolerance policy applying to breaches.

Separately, Mr Varadkar will today attend a meeting of the emergency department taskforce dealing with the trolley crisis.

Despite the provision of extra funding, trolley numbers were up 40 per cent last month compared to the previous August.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.