Catalogue of health service mismanagement and waste exposed

19/11/2008 - 18:48:33
A public spending watchdog today exposed a catalogue of mismanagement, waste and inefficiencies in the health services.

The Public Accounts Committee probed how €12bn was spent and how the 111,000 staff performed within the Health Service Executive.

The all-party body’s 30-page report criticised misuse of resources, abuse of the public/private system in hospitals, poor financial management and the high cost of medicines.

The report will be sent to the Finance Minister by the 12-member committee, which is chaired by FG TD Bernard Allen.

“The HSE is still trying to unscramble the scrambled egg left by the demise of the local health boards,” said Mr Allen.

“We found wastage and duplication and there needs to be tighter controls by management.

“I believe there are gross deficiencies in the health services.”

The committee found that the HSE’s 2006 accounts were in a format that was difficult to analyse.

“I wouldn’t say there was an attempt to cover up anything, but the accounting systems in place were defective,” noted Mr Allen.

The committee found that 640,000 euro was spent in 2001 on three houses in Castlepollard Co Westmeath which have not been used since their purchase, due, it claimed, to a lack of planning and budgeting.

Ms Shortall said: “The value of the houses has depreciated which has cost the taxpayer money. No funding was in place to furnish the houses or to recruit staff to care for patients, which have remained in institutional care during all this time.”

The report also found that a €1.5m euro Cat scanner in Mallow General Hospital has remained unused for the past two years because no staff are available to operate it.

Buildings, including listed dwellings, near Our Lady’s Hospital in Cork have lain idle for several years and some have even been vandalised during that period.

“The HSE doesn’t have a national database of its entire property portfolio,” added Mr Allen.

Criticising the National Treatment Purchase Fund, Mr Allen said: “Some consultants didn’t have enough time to treat a patient on the public system but found time to treat them privately.”

The report found that almost 4,000 patients were treated under the NTPF by a consultant who also had these patients on his public waiting list.

“I’m not happy at all that the NTPF is giving taxpayers value for their money,” added Mr Allen.

Ms Shortall said the way the NTPF is run left huge potential for abuse and she called for tighter monitoring of the scheme.

Committee members also slammed the 1997 consultants’ contract which it claimed was resulting in longer waiting lists in public hospitals.

“There was a failure on the part of the HSE, the former health boards and ultimately the Department of Health to put adequate systems in place to ensure that the 1997 consultants’ contract was operated as it was intended,” the report said.

“The 80:20 split for private practice in public hospitals was largely ignored ultimately to the detriment of public patients.”

Ms Shortall also criticised the lack of transparency with the HSE model because local health board chiefs could be grilled by councillors at monthly meetings.

The report also criticised sweeteners offered to GPs from drug companies so that would prescribe their branded products.

Mr Allen said he hoped that the Medical Council, which now included lay members, could look at this issue from an ethical point of view.

“The ethical guidelines of the Medical Council on the commercial relationships between GPs does not cover such issues as the amount of personal travel that doctors should accept form pharmaceutical companies.

The committee also found there was evidence of patients returning medicines such as antibiotics to pharmacies because they were being over-prescribed by their doctors.

Mr Allen added: “We shine a light into the areas of spending where those responsible for delivering our health services could and should have done better.”