Hospitals fined €7.5m for poor service

BADLY managed hospitals where patients’ health is not improved by high treatment costs have been fined €7.5 million.

Under the performance-related casemix assessment of 37 hospitals, James Connolly Memorial in Blanchardstown and St Columcille’s in Loughlinstown had their budgets cut by €1.4m and €1.05m, respectively, for inefficiencies.

Letterkenny General Hospital was top of the winners table, receiving €1.12m for improved performance, despite ongoing problems with A&E. A fortnight ago, the hospital cancelled scheduled surgery because of overcrowding in the emergency ward and 28 patients on trolleys.

Wexford General came in the top five, receiving €741,791 despite two consultants, as clinical directors, resigning last week in protest over bed shortages.

Failure to include an analysis of A&E under the casemix scheme - which compares activity and costs between hospitals - means the system of awarding some hospitals and penalising others is flawed, the Irish Hospital Consultant’s Association (IHCA) warned yesterday.

IHCA assistant secretary general Dónal Duffy said it failed to take into account the 70%-plus admissions through A&E. He said the IHCA was also concerned that badly underfunded hospitals were penalised even further under the casemix scheme.

“With long-stay patients and bed closures, many hospitals have little control over service delivery. The casemix system is supposed to be applied where all things are equal and in the current climate, they are certainly not,” he said.

A spokesperson for James Connolly Memorial, which hit rock bottom - down from second last in 2004 - blamed “cost containment measures” in 2003 for a negative effect on hospital activity.

However, the hospital was also penalised €1.08m the previous year. The spokesperson said they expected an improvement next year because activity levels had increased.

St Vincent’s in Dublin showed significant improvement in 2004. Last year, with ongoing problems of long patient treatment times and bedblocking, it topped the losers’ list and had its budget cut by €1.2m. This year, it was still in the red but its deduction was down to €179,025.

Cavan General and Monaghan General Hospitals, beset by problems this year with the suspension of consultants at Cavan (lifted in the past few days) and the removal of on-call at Monaghan (recently restored), were fined €346,384 and €368,606, respectively.

Monaghan Hospital Community Alliance chairman Peadar McMahon said it was very unfair to penalise either hospital “when you consider the conditions in which they had to operate for the past two or three years”.

A Department of Health spokesperson defended the casemix scheme, saying it was an internationally recognised model of assessing treatment costs to analyse hospital performance.

The rewards

Letterkenny: €1.12m.

Longford/Westmeath: €901,434.

UCH Galway: €802,937.

Cork University: €765,904.

The penalties

James Connolly Memorial: €1.9m.

St Columcille’s: €1.05m.

St James: €827,625.

Mayo General: €613,409.

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