Overspending in the HSE mounted to €360m last year partly due to failed savings in drug payments, the recouping of private bed costs, and the use of agency staff.
A damning Oireachtas report has concluded that the HSE’s financial management systems are “no longer fit for purpose”.
Government TDs criticised the HSE yesterday, but laid the blame for failed savings and overspending firmly with the agency rather than with Health Minister James Reilly.
The Public Accounts Committee report, revealed by the Irish Examiner earlier this year, found that millions of euro in anticipated savings and extra income did not materialise.
TDs concluded that the “most disturbing” finding was a failure to collect €74m in funds from health insurers because consultants had not signed off on claim forms for the treatment of private patients in public hospitals.
This was “no way to run a health service”, the committee found.
Other failed savings included €124m that did not materialise from promised reductions in drug payments, as well as €100m from savings in the use of agency staff.
PAC chairman John McGuinness said: “In living within its budget, it [the HSE] needs to ensure that its services are accurately costed and that appropriate provision is made in the estimates, especially for demand-led services and that it collects the money it is owed.”
The committee heard at one stage last year that consultants were taking between two to three months to sign off on forms which enabled claims to be submitted. By October, about €74m was outstanding because of forms not signed off on by consultants.
PAC member Simon Harris said consultants needed to “cop on”.
Mr McGuinness said yesterday that the PAC was still awaiting an update from the HSE on the amount in private patients costs that remained to be cleared with insurers.
Members have recommended that hospitals where consultants fail to sign such forms in reasonable time should be named and shamed.
While increased hospital activity and medical card demand had pushed up spending, promised savings in other areas were never made.
A 50% cut in the €200m annual spend on hiring agency staff was “unrealistic” and never materialised, the report said.
Concerns were also raised about the oversight of voluntary bodies, including public hospitals. A more detailed scrutiny was needed of the 16 voluntary hospitals, it said.
A review of rest days paid to retiring consultants was also called for by PAC, with the most recent figures showing that 31 consultants were paid sums ranging from €15,000 to as high as €200,000 in 2011.
PAC member and Fine Gael TD Paschal Donohue said the HSE spending problems proved that the health service should be under the “direct resolution” of Dr Reilly, as is planned.
Mr McGuinness said Dr Reilly needed to take note of the PAC’s report.
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