The Health Service Executive proposed paying €1 million a weekend to get consultants to attend hospitals and to secure additional diagnostics for patients at the height of the recent emergency department overcrowding crisis.
HSE director general Tony O'Brien told the Department of Health in late January a €20 million overall package of short-term measures and incentives was needed to support hospitals and improve the flow of patients.
As part of such an initiative, he suggested up to €5 million in additional expenditure was needed to support the discharge of patients at weekends by consultants.
He said €5 million would pay for “senior clinical decision-makers” to attend hospitals for four hours every Saturday and Sunday for a five-week period. He said it would also include provision of €2 million for additional diagnostic services to be provided to patients at the weekend.
Arrangements
Mr O’Brien said it was envisaged such an initiative would be in addition to existing on-call arrangements.
The HSE chief also suggested “some form of incremental payments such as a higher overtime rate” could be offered to nurses to facilitate the provision of additional hospital capacity.
Department of Health secretary general Jim Breslin told the HSE in reply that the €20 million for the proposed package of measures would have to come from the health authority's existing budget, which, he maintained, had been increased by 7 per cent.
He said the department believed weekend discharge procedures “should be the norm in hospitals”. He also argued this should not be limited to a five-week period.
“The 2008 consultant contract expressly provides for payment for structured on-site attendances by consultants where it has been determined by the employer that it is required. The costs must be met from within existing resources.”
The Department of Health completely rejected the provision of new overtime arrangements or other financial incentives to nurses who worked less than full-time hours or any departure from existing overtime arrangements.
