Latest news with #Gloster
RTÉ News
06-07-2025
- Health
- RTÉ News
HSE chief highlights issues with third party insourcing
HSE Chief Executive Bernard Gloster has said an increase in dependency on third party "insourcing" in hospitals can create a number of problems. Mr Gloster said issues include disincentivising normal work delivery, limiting productivity and limiting opportunities to reform the service. Insourcing is where third parties or companies deliver care in hospitals outside normal hours. It is paid for by the State and, in some cases, is provided by HSE staff. The initiative was brought in to reduce long waiting list times for patients. Speaking on RTÉ's This Week, he said that a fundamental issue with third party insourcing is that a higher premium is paid, which means that some staff were being incentivised. Mr Gloster said that the majority of people who participate in insourcing are "good honest people" doing what they have been asked to do. However, he said that third party insourcing can create "significant conflict of interest" and "seriously undermine" compliance with procurement regulations. He said in a small number of instances, there have been indications of concern as to whether or not it is being used for what it is intended for. Mr Gloster said that we have "developed a dependency" on something that is a disincentive to the other types of reform, like the public only contract being distributed beyond the five-day week, because the same staff are involved. He said he provided a HSE report on the issue of insourcing and outsourcing to Minister for Health Jennifer Carroll MacNeill last Monday, which she has published. He said the minister has committed to coming back to the Oireachtas Health Committee by the end of this month with a set of decisions and actions in terms of reducing dependency on third party insourcing. Mr Gloster agreed that it is his strong recommendation that it be ended. The HSE report, carried out by Mr Gloster, found that 83 current and former staff are directors in 148 companies providing this care. He said that the holding of a company directorship is not illegal but he said it brings a level of "perverse incentive" that is not sustainable. Asked if third party insourcing was stopped too quickly and would it push waiting times up, he said that this is why he has recommended a longer time frame to phase it out with additional controls and oversight. In relation to audits on three hospitals over concerns about the use of these waiting list funds,he said that he has to wait for the internal audit reports to see if the complaints have any substance. He said the purpose of the report he has given to the minister is to come to a sensible set of actions, aimed at improving waiting list management and reducing risks. Asked if money was being used appropriately for outsourcing initiatives, he said that oversight, corporate governance and the avoidance of conflict of interest is easier in outsourcing arrangements. Commenting on the CHI internal report being referred to gardaí, he said there were issues in relation to the individual care of people and how they were or were not managed on waiting lists. Asked if he was confident that CHI was the right entity to manage the new children's hospital he said that he has "every confidence" in the new CHI CEO Lucy Nugent. However, he said is in no doubt that this is an entity that faces a scale of challenges and historical and cultural issues.
Irish Examiner
02-07-2025
- Health
- Irish Examiner
Some health services would collapse if 'insourcing' ended overnight, HSE head says
Some health services could collapse if funding for top-up care known as 'insourcing' is removed too suddenly, the Oireachtas Health Committee has heard. The discussion followed publication on Tuesday of a HSE report showing almost €100m was spent in just 27 months on this funding. It is given by the National Treatment Purchase Fund (NTPF) to hospitals for reducing waiting lists. However questions have arisen over how this is used, including at Children's Health Ireland. HSE CEO Bernard Gloster said he now expects this funding will be eased out by June 30 next year. He told the committee he asked about the impact of ceasing these payments overnight. 'The system came back to me and said 'if we were to do that in the way you've asked right now, these are the following services that will collapse today,'' he said. He expanded on how enmeshed the top-up funding is in the HSE in response to Senator Teresa Costello. 'There's only one way you can change the culture of dependency on insourcing and that's to end it, that's it, there's no other way to do it,' he said. "You have to end it sensibly and over time.' Staff, he stressed, only did what they were asked as until recently there were few questions asked. He acknowledged this is a failure of governance. Answering questions from Fianna Fáil TD Padraig O'Sullivan, he accepted extra clinics funded by the NTPF offer attractive pay rates to staff involved. 'In the level of the scale of it, I think we took our eye off the ball,' the CEO said. It is very difficult to ask a nurse or anyone else to do ordinary overtime on a Saturday when the possibility now exists that in a different construct, they can get paid much more significantly. The report shows the HSE is giving notice they will not renew or enter in contracts with external providers of insourcing care. Any agreements between now and June need to be approved item by item by hospital CEOs. The report warns of potential impacts including conflicts of interest, non-compliance with HSE procurement rules and risk of abuse or fraud among other issues. Out of 950 companies involved, the bulk is done by 50 larger companies, HSE CFO Stephen Mulvany, told Sinn Féin health spokesman David Cullinane. Some 534 work in hospitals, other clinics mentioned included offering Assessment of Need in the disability sector. 'Perverse incentives' Mr Cullinane asked about 'perverse incentives' and links between the HSE and these external companies. Analysis of directors in 148 companies found 83 staff with links to the HSE or health bodies funded by the HSE under Section 38 arrangements, including some serving staff, Mr Gloster explained. NTPF CEO Fiona Brady defended its oversight processes. She said she is not aware of problems identified by Beaumont Hospital being replicated in other hospitals. A HSE internal audit team has been examining that issue since April, she confirmed to Labour health spokeswoman Marie Sherlock. Mr Gloster also said in the case of University Hospital Limerick (UHL), insourcing funding has helped patients. He told Senator Maria Byrne: 'The weighted average (waiting) time in UHL is below the national average, which is a really significant achievement - because it is the time people are waiting. And you can say ok there was in-sourcing involved in that but at least there was a return.' Regional executive director for the HSE Midwest, Sandra Broderick, said they have made funding requests to hire more specialist consultants to address these waiting lists internally.
RTÉ News
02-07-2025
- Health
- RTÉ News
HSE chief to warn of overreliance on insourcing work in public hospitals
HSE Chief Executive Bernard Gloster is to warn of an overreliance on insourcing work in public hospitals, to support core care and cut waiting lists and has said the dependency on this funding needs to be removed. It comes after recent controversies involving funds provided to three public hospitals by the National Treatment Purchase Fund to cut waiting lists. A new report from the Health Service Executive CEO has revealed that Naas Hospital is also the subject of an internal audit. Previously a Children's Health Ireland hospital and Beaumont Hospital had been identified where internal audits were under way for different reasons. Mr Gloster will tell the Oireachtas Committee on Health that this insourcing work involves public hospitals engaging external companies, or third party suppliers to deliver services, often outside of normal working hours, using HSE-owned equipment facilities and equipment. In many cases, the outside providers may employ or subcontract staff who are already directly employed by the Health Service Executive, effectively reengaging internal staff through a separate commercial arrangement, typically at premium rates. Mr Gloster will say that a 27 month review by the executive of insourcing and outsourcing work has found that around €100 million was used for this insourcing work. It amounted to over 253,400 instances of care, much of it funded by the National Treatment Purchase Fund (NTPF). Mr Gloster will say that what he is referring to as insourcing, is not the use of standard overtime within employment contract arrangements of existing HSE staff. The 27 month review covered 2023/2023 and the first quarter of this year. It identified an outsourcing and insourcing spend of €1.1 billion for the period in review. Most of this was for outsourcing, which ranged from securing private hospital care, to private ambulances and laboratory products. Not all outsourcing was for waiting list management. Mr Gloster will tell the committee that earlier this year, Minister for Health Jennifer Carroll MacNeill asked him to conduct a national review, with a particular focus on insourcing, and the level of activity and dependency on it. He submitted that report to the minister this week. Mr Gloster will tell the committee that insourcing by its nature carries risks, and that he has agreed with the minister the need to reduce these risks, and increase the safeguards and remove dependency on insourcing. The committee will also hear from the NTPF, which helps pay hospitals to cut waiting lists, through insourcing arrangements with public hospitals and outsourcing arrangements with private hospitals. It will tell the committee that 30% of its commissioning involves insourcing. This has been at the centre of recent media coverage, involving Children's Health Ireland and Beaumont Hospital and the use of NTPF funds. The NTPF suspended insource funding to Children's Health Ireland in May, after a leaked report found that a consultant at one hospital had breached the fund guidelines by referring patients to the doctor's own weekend clinics. Funding was later restored after the NTPF secured assurances from CHI. The NTPF also suspended funding to Beaumont Hospital in April, due to a separate issue to what was found in the internal CHI review. The Beaumont issue did not relate to a consultant-led issue. In March, Beaumont Hospital had approached the NTPF of its own volition about activity conducted as part of insourcing work under the waiting list initiative. An independent review of the matters is under way by the HSE's Internal Audit Team and the committee heard previously that it involves potential financial irregularities. The NTPF will tell the committee hearing that it takes its responsibility to manage public funds with the utmost seriousness. It says that internal governance of insourcing remains with the referring public hospital, under a Memorandum of Agreement with the NTPF, for the money to be used as specified and agreed. Payments are only made to the hospital by the NTPF, not to any individual consultant, or staff member. Since 2019, the NTPF said it has arranged surgery or care for around one million public patients. 83 current, former health service staff acting as directors in 148 companies A HSE report for the Minister for Health has found that 83 current, or former health service staff, have been acting as directors in 148 companies, providing insourcing or outsourcing services for public hospitals to cut waiting lists. The report by Mr Gloster says that of the 83 individuals, 58 were HSE and 25 were with Section 38 health agencies funded by the HSE. Of the HSE individuals, 35 are former HSE employees and 23 are serving employees. Mr Gloster notes that there is nothing unlawful in being a company director, and there are equally obligations in respect of Standards in Public Office and or employment contract terms. However, these issue were not assessed for this preliminary analysis. "More testing and refinement is needed however this notwithstanding, I am advised than in an audit context this is a higher end level of return on such a search," Mr Gloster states in the report, published by the Minister for Health and also being provided to the Oireachtas Committee on Health members. The analysis looked at 148 companies covering 365 listed directors and compared names, date of birth and address, against current and former HSE employees. There were 93 matches. The report says there is a need to put in place more robust safeguards following recent reports and events which have affected public confidence.
The Journal
02-07-2025
- Health
- The Journal
HSE chief admits waiting lists for assessments for children with disabilities will get worse
THE HEAD OF the Health Service Executive (HSE) has said he is 'hugely' concerned at growing waiting lists for disabled children seeking vital health assessments, and admitted the crisis will get worse. Bernard Gloster acknowledged a 'significant challenge' in tackling the crisis, with more than 15,000 children with serious disabilities waiting to access their legal right to assessments. When asked if the crisis was 'going to get worse before it got better', Gloster said 'yes'. 'Until we get extra capacity and until we reform the legislation, we are going to be challenged,' the HSE chief said. 'It would be very wrong of me to say anything different to people across the country, it would be untruthful to do that,' he told reporters in Limerick. The HSE predicts that the children's assessment waiting lists will increase to beyond 25,000 by the end of this year. After meeting Cara Daramody, a fourteen year old campaigner for the rights of children with disabilities, Gloster pledged that the HSE will advertise tenders for assessments to the private clinicians, to try and tackle the problem. Prior to the meeting, Cara Darmody, accompanied by her father Mark Darmody, called out the government via the HSE for breaching current legislation requiring it to provide health and education needs assessments for children with disabilities. Ms Darmody said children had been left to 'rot' on the waiting lists and urged Gloster to act fast to rescue the waiting list backlog for the vital assessments. Ms Darmody, who led a 50-hour protest outside the Dail last month highlighting the crisis, said she gave Gloster 'crucial information that totally contradicts the myth that capacity has been reached in the system in relation to the number of psychologists available to assess autistic children'. She said that she also informed the HSE chief that she is aware of 'private' clinicians who have sought to help reduce assessment waiting lists but who have been delayed in doing so by bureaucracy. Bernard Gloster pictured with activist Cara Darmody and her father Mark. Brendan Gleeson Brendan Gleeson Ms Darmody claimed she knows of at least one private clinician who could have 'eradicated' the AON waiting list in her home county of Tipperary county over the last 12 months, by performing an additional 220 AONs, had they been given the opportunity. She said the clinician had applied for a HSE Assessment Tender last October, 'but only got confirmation a month ago' that they had been accepted. Ms Darmody questioned 'why in the middle of a national crisis did it take eight months', and she accused the government of not acting fast enough on the waiting lists. Advertisement Gloster said this evening he was 'taken aback' at the details presented to him by Cara Darmody and Mark Darmody. Commentating on the alleged eight-month wait for the provision of the assessment tender, Gloster said: 'I have to say, it can happen, we are a very big organisation and we have to have rules and systems, and they, by their nature, can become bureaucratic.' 'I'm the first to put my hands up and say, that's for us to do better.' 'I don't think that my own people are doing anything bad or wrong, but it is for us to better, we are paid public servants and Cara and her Dad are not.' Gloster said, going forward, he would try to 'tighten the timeline' on assessment tenders applications by the private sector. He acknowledged that 'in the short-term' the HSE required 'help' from the private system to help reduce the assessment waiting lists. 'In the next few weeks we are going to redesign the specification of private sector provision to help us provide assessment of need,' Gloster said. 'We are going to widely advertise and promote it, so that if there are suitably qualified clinicians who can conduct an assessment of need, and who are qualified and registered to do so, and are safe to do so, then there will be no issue with us using that additional capacity,' he said. 'Even if it possibly reduced the timeline for a couple of hundred (children), then it would be a really productive thing.' Gloster said: 'If you apply for an assessment of need, you are entitled to it in law, you should be able to get it.' The Limerick health service boss said other 'challenges' existed beyond the assessments, including timelines over children's access to 'therapeutic support and intervention'. 'The amount of therapists we have in Ireland that are available to us is limited, but the government are making some really good interventions to increase the supply,' he said. Gloster said that Cara and Mark Darmody's 'anecdotal evidence' of a possible reduction in the waiting lists may exist in the private system, their arguments to investigate it further was 'legitimate and appropriate'. Gloster acknowledged that it had been 'a while' since the HSE had 'updated' its 'framework' of assessment providers, 'so, therefore, there is nothing to loose and everything to gain' by investigating potential capacity in the private system. 'If (it is) proven that there is capacity out there that isn't being used, we'll be delighted that more that can be done, because it means that we can immediately enter into arrangements with professionals to buy additional services to support our own (services),' Mr Gloster said. Ms Darmody described their meeting as 'extremely successful'. 'I got what I wanted from the meeting, which was for Mr Gloster to look into the issue and to start looking for solutions nationally, and in my own county Tipperary, and possibly internationally,' Ms Darmody said. Readers like you are keeping these stories free for everyone... A mix of advertising and supporting contributions helps keep paywalls away from valuable information like this article. Over 5,000 readers like you have already stepped up and support us with a monthly payment or a once-off donation. Learn More Support The Journal
NDTV
26-06-2025
- Automotive
- NDTV
JSW MG Motor India To Increase Prices Across Model Lineup From July 1
JSW MG Motor India has announced a price hike of up to 1.5 per cent, covering the majority of models in their lineup. The changes in vehicle prices will take effect on July 1, 2025. It is worth noting that the extent of price changes will depend on the model and variant. As per the automaker, the revision in the prices of the vehicles has been made because of rising input costs and economic adjustments. The current range of cars with the MG badge begins with the Comet EV, which comes at a starting price of Rs 4.99 lakh (ex-showroom). It is followed by the Windsor EV, which comes at Rs 10 lakh (ex-showroom). After this, you enter the range of ICE cars, starting with Astor at Rs 11.30 lakh (ex-showroom). The next in line is Hector at Rs 17.5 lakh (ex-showroom), with the top spot taken by the Gloster at Rs 41.07 lakh (ex-showroom). The electric cars in the brand's portfolio offer consumers Battery-as-a-Service (BaaS). This model is aimed at reducing the initial cost of the vehicle for consumers by separating the battery cost from the car's price. Hence, making electric vehicle ownership accessible. MG Motor is gearing up to venture into the luxury market with an array of new products. The company has revealed plans to launch the M9 Limousine, signaling its entry into the high-end vehicle segment. Later this year, MG will also launch the Cyberster, an electric convertible sports car that aims to enhance performance-focused innovation within its EV lineup. Both of these premium vehicles will be sold through a newly established dealership network, MG Select, which is designed to offer a more exclusive customer experience. Additionally, the automaker has provided a preview of the Majestor. This could be a luxury SUV concept derived from the Gloster. The Majestor is anticipated to join the lineup in the upcoming months, indicating MG's ambition to expand its premium offerings in the Indian market.
