The State’s seven hospital group chief executives have been warned they could face removal from their positions if they fail to control spending.
In a bid to curb overspending in the health service, new accountability measures have been agreed between the Government and the Health Service Executive under which the "personal performance" of chief executives and other managers may be addressed.
The chief executives have been told in a letter from the HSE that severe sanctions for underperformance may include the publication of performance notices issued against them.
The revised accountability framework is understood to have been proposed by the director general of the HSE, Tony O'Brien, and agreed by Taoiseach Enda Kenny and Minister for Health Simon Harris earlier this week.
The correspondence issued to the chief executives said no additional money would be given to the HSE this year and each hospital must live within its budget.
Performance notices
From next month, if there is evidence that a financial plan is not being adhered to, a performance notice will be issued against the individual chief executive.
If there is no improvement within a month, a second notice will be sent with an additional four weeks to comply.
The letter states further action will be taken at that point if performance goals are not met.
“This may then become a matter of your personal performance or, in the case of statutory hospitals, the personal performance of named managers reporting to you.”
In the cases of so-called section 38 and 39 agencies, which are funded by the HSE, funding will be withheld and all requests for additional services will be precluded until the issues are addressed.
The 11-page correspondence also warns managers their performance may be the subject of investigation.
A formal performance-achievement process may be invoked which could “ultimately culminate in removal of the named manager from post and or reassignment to other duties”.
The correspondence was sent to each of the hospital group chief executives on Thursday afternoon.
It states: “It is important not to underestimate the likely far-reaching consequences for individuals and services if there is a failure to manage within this funding level.”
It says the chief executives could also be called before Oireachtas committees to explain their failure to comply.
Overrun prevention
The HSE was given an additional €500 million last month to prevent overruns this year.
The letter says that the money is being underpinned by an enhanced performance and accountability framework, with health service managers being held accountable for performing within their revised budget.
Each hospital group chief executive has been asked to establish formal arrangements with individual hospitals to ensure delivery against targets.
Individual managers will be tasked with identifying issues of underperformance in each hospital and requested to act on them promptly.
The chief executives, who were given their funding allocations yesterday, were asked in the letter to respond with a financial plan, by month, for the remainder of the year identifying the associated actions to control spending.
The HSE also asked them to report back every month to assess if the plan is working.
The chief executives have been told “immediate remedial actions” must be taken if difficulties are identified.