Latest news with #OireachtasHealthCommittee
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.
Irish Examiner
26-06-2025
- Health
- Irish Examiner
HSE apologises for two-year delay in North Kerry children's mental health review
The HSE has apologised for the fact that a review of 300 children in mental health services in North Kerry has taken two years and is still not complete. The report is only at draft stage, minister of state for mental health Mary Butler told the Oireachtas Health Committee on Wednesday morning. She also said that 'red flags' identified in children's care have already led to individual open disclosure meetings between families and the HSE. After the committee, a spokeswoman for HSE Southwest said: 'We sincerely regret that this review process has taken longer than we initially hoped, and we apologise to the young people involved and their families.' She said it is not yet possible to give a definitive completion date. 'It is important to point out that all individual young people and families have already been told what the review team found in relation to their care,' she said. 'The information was provided in person at individual open disclosure meetings detailing the full clinical details available in relation to the cases involved where necessary.' The final report will contain recommendations from Dr Colette Halpin and her expert team, as well as relevant clinical information. The look-back review was set up after the shocking findings from the Maskey Report on CAMHS in South Kerry, which included evidence of 'significant harm' caused to 46 children among the 240 whose care was deemed substandard.
Irish Examiner
25-06-2025
- Health
- Irish Examiner
'Red flags' raised during review of children's mental health care in north Kerry
A review of children's mental health care in north Kerry that started in 2023 is still not finished, but so many 'red flags' were already raised that some children needed open disclosure meetings, the Oireachtas Health Committee heard on Wednesday. The review was announced following shocking findings in the Maskey review around mis-prescribing and harm to children in Child and Adolescent Mental Health Services (Camhs) in South Kerry. Minister of state for mental health Mary Butler was among the health ministers speaking to the committee on a range of financial and policy issues. In response to TD Michael Cahill, she said a senior clinician was appointed to run a review in North Kerry. 'It was hoped the review would be completed in a short period with Dr Colette Halpin, but unfortunately they realised it would take longer,' she said. 'Red flags were raised immediately and they had to undertake a robust review of all cases. The HSE's priority was that every file of every young person would get a thorough and robust review.' She added: 'During the review any young person whose file showed deficits in the care provided to them, they were called for an individual open disclosure meeting, so that's happening the whole way through.' A final report is being drafted, she explained, saying once the HSE receive that draft, additional work will be needed before it is published. Ms Butler also said that out of the 240 children affected by findings in the Maskey report, 228 applications were made to an non-adversarial compensation scheme by May. Some 222 payments have been made, and she welcomed that 'you're not dragging people through the courts' with this approach. University Hospital Kerry overcrowding Mr Cahill also asked about funding plans for University Hospital Kerry in light of ongoing overcrowding. He described cases of 'elderly patients falling off chairs' in the waiting room, and said at least one patient spent days on a trolley in the emergency department. Health minister Jennifer Carroll MacNeill said while there are bed shortages, this is not the main problem, unlike in University Hospital Limerick. She called for tighter management of beds. 'There is in Kerry a new ward block which is at design feasibility stage in accordance with the acute inpatient capacity expansion plan,' she said. Some 160 new beds are planned nationally this year, and she said Caherciveen Community Hospital is in the mix for this. Health sector finances On the broader financial crisis in health, the committee heard HSE spending on agency staff rose every year for the last three years, reaching at least €734m last year. The spend last year was 7.6% higher than in 2023 just for agency staff funded through Department of Health funding streams. It was also 9% higher than 2022. Plans to hire agency workers and convert them into full-time or part-time staff, which would reduce costs, have also not progressed as quickly as first hoped. Ms Carroll MacNeill said there was a budget of €80m for conversion. 'That's partly offset by a €60m increase in pay where there's conversion, the conversion process really began in July 2024,' she said. Ms Carroll MacNeill told Labour TD Marie Sherlock that 512 agency staff have been hired by the HSE, the latest data she had showed. However, she added that this 'is 53% of the target'. Read More Cork and Kerry mental health services have fewer staff now than during staffing crisis two years ago
Irish Daily Mirror
19-06-2025
- Health
- Irish Daily Mirror
CHI admits parents not told kids could have fertility issues due to delayed care
Parents with children at risk of fertility issues and cancer due to delayed procedures have not been told of the risks to their children, Children's Health Ireland has admitted. Lucy Nugent, Chief Executive of Children's Health Ireland (CHI), also told the Oireachtas Health Committee that parents were not told about concerns in the oncology department or that their children with spina bifida were being referred to as 'Crumlin Orphans' and were receiving "sub-optimal care". The concerns were raised in a 2021 report by CHI, which has been seen by the Irish Mirror but has not been published by CHI due to legal advice. CHI attended the Oireachtas Health Committee on Thursday to apologise for the litany of scandals engulfing the body, including the unauthorised use of springs in children's spinal surgeries, hip dysplasia surgeries and reports on staff in CHI hospitals. A 2021 CHI report, seen by the Irish Mirror, highlights several issues relating to the timely treatment of children and culture within CHI. The report stated that "some patients, who were placed on the inpatient waiting list, were confirmed as having undescended testes, a condition which requires surgical intervention within a specific timeframe". It continued: "Placing these patients on a specific consultant's inpatient waiting list, when it was known there were alternative options which would have ensured these patients could have been operated on sooner, appears not to be in the best interest of [the] child and the specifics of each case warrant further examination." In a section on urology general surgery waiting lists, the report stated that there were 10 patients on an inpatient waiting list in 2021 requiring a surgery called orchidopexy for this issue. It noted that they were "at risk if their wait time extends past their first birthday". Sinn Féin's David Cullinane told the Health Committee that patients who are waiting "far in excess of the recommended timeframe for that treatment" were placed at "real and known risk for fertility issues or cancer". When asked if these patients had been identified and their parents contacted, Ms Nugent said open disclosure was "discussed at the time with the clinical experts". She said: "They did not meet the threshold for open disclosure." Senator Tom Clonan told CHI that if it were "running Tayto Park, I wouldn't let my children go there". In response to his questions about how many children were at risk of infertility due to delayed urology procedures, CHI Chief Medical Officer Dr Allan Goldman stated that it was "impossible to say". Senator Clonan responded: "That is an ongoing, systemic and systematic failure of our children, disabled children, being de facto sterilised for lack of intervention on your watch." Deputy Cullinane also asked about the concerns raised in the report about oncology services. He stated that an August 2021 risk assessment scored these services 20 out of 25, or "high risk". Deputy Cullinane read from the report: "Pediatric oncology patients have a poor experience or are harmed due to the inability of CHI to deliver international best practice standards. Again, it talks about prolonged recoveries." Ms Nugent said "to the best of her knowledge", these concerns were not relayed to parents. Similarly, the report raised issues about 'Crumlin Orphans'. These children were not transferred to Temple Street Children's Hospital when the service was moved and the CHI report said they received "sub-optimal care." Ms Nugent stated that these parents were also not notified of these issues or given another unpublished report on the issue, called the Dixon Report. Kate Killeen White, HSE Regional Executive Officer, confirmed to the Health Committee that she referred the 2021 CHI report to the Gardaí earlier this month. She stated that the HSE only became aware of the report on May 25, the same day details of it were published in the Sunday Times. Ms Killeen White said that both before and after the report was referred to gardaí, CHI expressed their belief that it "did not meet the threshold for criminality". Fine Gael's Brian Brennan, who declined to get hip dysplasia for his son, warned that the scandals engulfing CHI would become 'one of the biggest medical malpractices in the history of the State". Fianna Fáil TD Martin Daly, who was a doctor for 40 years before entering politics, said, "There is absolutely zero confidence in CHI, zero confidence in the management." He continued: "I am speaking as a medical professional who would be inclined to try and tease out the nuances of this? There are no nuances." As Deputy Daly stated that he did not believe Ms Nugent's opening statement conveyed the gravity of the situation, the CHI Chief said: "It keeps me awake."
Irish Examiner
11-06-2025
- Health
- Irish Examiner
Mental Health Bill may delay treatment for teenagers, Oireachtas committee hears
It is unclear whether the Mental Health Bill will help teenagers in crisis, including those in Kerry, with some sections likely to cause delays rather than improvements, the Oireachtas Health Committee heard on Wednesday. Shortages of specially trained authorised personnel to assist patients in crisis were also discussed by An Garda Síochána, in light of a new project in Limerick. This was the committee's first sitting since the November election, and their first opportunity to scrutinise a bill that could be in place for the next 25 years. Committee chair Pádraig Rice expressed his 'frustration' with the timing. Normally, there would be a gap between the committee and Dáil discussions, but this Bill will go before the Dáil just hours later. The Government tabled 298 amendments on Tuesday afternoon. 'I don't think it's in line with best practice and I don't think it's the way to deal with a Bill of this scale,' he warned. Speakers raised concerns about gaps in crisis care for teenagers aged 16 to 18. Child and Adolescent Mental Health Services (Camhs) supports patients up to 18, but paediatric emergency departments stop at 16. Committee chair Pádraig Rice expressed his 'frustration' with the timing. Picture: Niall Carson/PA Wire Irish Medical Organisation Consultant Committee Chair Dr Matthew Sadlier described a case where a 17-year-old spent a week in an emergency department. 'We couldn't admit them to the acute adult unit because we were too scared we going to get given out to and told we were torturing somebody and abusing their human rights,' he said. ' There was no bed available in the child unit, now where was the most suitable place for that child, a 17-year-old, to be?'. Answering questions about South Kerry Camhs, the focus of critical reports including the Maskey review, he said the Bill does not address staffing gaps that led to these problems. Recruiting for isolated rural services in Kerry or Donegal is more difficult than in cities, so discussions with staff and employers must come first, he explained. The Mental Health Commission welcomed the expansion of its remit in some areas under the Bill but supported calls from two Garda speakers for more attention to the authorised persons issue. Assistant Commissioner Paula Hilman said a pilot programme in Limerick, run jointly by Gardaí and the HSE, has helped 'over 40' people avoid arrest or detention by offering support services. None of them needed to go to the Limerick ED. However, she raised serious concerns that the Bill will worsen national shortages of trained staff. 'It is the experience of our CAST team that there is a need for a 24-hour, seven-day-a-week service to support delivery in this area,' she said. She added: 'We further contend that only allowing Authorised Officers to make an application, could add to the already adversarial and structured process – and potentially cause significant delays to a person receiving treatment.' Dr Brendan Kelly, also of the IMO, warned of ongoing concern that the criteria for involuntary admission and treatment differ. This could result in someone being admitted but not receiving treatment, he explained. Mental Health Reform interim CEO Philip Watt said: 'The key thing really is definition, so no matter what term is used there has to be clarity on the definitions'. There are approximately 2,000 involuntary admissions each year in Ireland.
