HSE urged to reform as huge regional funding gaps emerge

THE amount of health funding allocated per head of population varies widely depending on where you live, from more than €4,500 per capita in west Cork to less than €600 in Co Meath, a report shows.

The report, which recommends the urgent introduction of a new model of resource allocation, proposes the Health Service Executive (HSE) takes the size, age and sex of the relevant population into account when making funding decisions.

Currently, 32 local health offices (LHOs) have managerial responsibility for ensuring services are provided to the resident population of that area. However, the system is not straightforward because a number of agencies working within an LHO area may offer services that overlap, or have separate funding streams. There may also be separate boundaries for primary care, hospital services and mental health, making it difficult to administer funding.

The report, Towards a Model of Resource Allocation for Primary, Community and Continuing Care in the health services, found two distinct problems: the resources per capita vary greatly between local health offices (LHOs), for historical reasons; and the financial systems do not permit proper analysis at LHO level.

Professor Anthony Staines of Dublin City University, principal investigator of the research team, said their proposed model would “be fairer, and would ensure greater accountability”.

“At present it is difficult to ascertain exactly how resources are allocated between care groups at LHO level. Budgets do not reflect service provision to the population at LHO level, and there is no real systematic approach to resource allocation,” Prof Staines said.

He said it was “a matter of urgency” that their new model be implemented in a staged manner.

The report recommends one unit within the HSE should have direct operational responsibility for running all the major health information systems and that the HSE should establish a small group including HSE staff, civil servants, academics and others with responsibility for developing and maintaining the resource allocation model.

It also recommends a unique personal identification number for all patients instead of the current situation where people can have more than one identifier.

A spokesperson for the HSE said it was not commenting on the report.