Voluntary hospitals criticise 'heavy hand of centralised control' by HSE

The Irish Voluntary Healthcare Association's members includes the Mercy University Hospital in Cork. Picture: Denis Scannell

The head of the association representing the country's 19 voluntary hospitals has criticised the "heavy hand of centralised control" by the HSE over the hospitals.

The Irish Voluntary Healthcare Association's members include the Mercy University Hospital in Cork, Children’s Health Ireland and Our Lady’s Hospice & Care Services.

Voluntary hospitals are run by boards or private bodies, but also receive a large proportion of their funding from the HSE.

The association’s chief executive Mo Flynn said their independent nature within the health service lacks recognition.

“We want to work with them as partners,” she said. “And to have a relationship that holds us accountable but also lets us get on with actually running our hospitals and organisations, without the heavy hand of centralised control or the bureaucratic hand that can at times disincentivise and disable the ability to actually deliver good services.” 

Ms Flynn said there is a real issue with “lack of recognition of the independent nature of the voluntary hospitals". 

"There’s been a considerable blurring of the issues around accountability and autonomy between the HSE and the hospitals now in the last number of years.”

However she said the biggest concern is “the very grave funding situation” now.

“There’s inadequate funding and a lack of clarity regarding funding as we move forward. You are seeing hospitals seeking professional advice regarding insolvency risks yet having to continue to operate on a day-to-day basis.” 

Some are facing the possibility of having to reduce services, she said.

“Most of our members were notified of significant deficits they are being asked to carry from 2023,” she said. "I think we are looking at a cumulative deficit of €340m across our members, between 2023 and 2024.” 

The voluntary sites are also seeing a rise in patient numbers as well as struggles to hire enough staff, she said.

A spokeswoman for the Department of Health said voluntary organisations play “a key role in service delivery” across health and social care.

The HSE is being restructured into health regions with new regional executive officers already in place, she said adding it is "essential" there is a formal recognition of the voluntary bodies within these new regions.

The Department, HSE and voluntary organisations have met four times in the last year to discuss these changes, and co-design a plan.

“This proposal is at advanced stage and has been subject to a significant amount of consultation and feedback from voluntary organisations which is being incorporated presently. We anticipate agreeing this document shortly,” she said.

The Irish Examiner reported last week the HSE is allocating €1.174bn as once-off supplementary funding to be shared by all funded hospitals and community services.

This funding will not cover the full stated deficit for each site. The supplement is linked to financial concerns around the overall budget, which shows a net deficit of €1.5bn.