News Irish News

Tuesday 20 February 2018

Fewer overnight stays in plan to reduce hospitals bill

James Reilly
James Reilly

Eilish O'Regan Health Correspondent

MORE patients are expected to be admitted to hospital on the morning of their surgery, rather than the night before, under a new funding system to be introduced next year.

Hospitals will be financially incentivised to become more efficient – but it is still unclear how patient waiting lists will be affected.

Under a new system of funding announced by Health Minister James Reilly, pictured, hospitals will no longer get block funding from 2014 and instead the "money will follow the patient".

This means the hospitals will be paid for each hip operation they carry out, for example.

The fee will take into account the needs of each case, such as the patient's age and length of stay, which would add to costs.

Hospitals will be under more pressure to bring patients into hospital on the morning of their surgery rather than the night before. They will also do more work on a day-care basis.

Department of Health officials insist that quality and safety would be built into the system and patients would not lose out.

The aim is to share out more surgery and in-patient procedures among hospitals, which are to be grouped under new proposals to be introduced shortly.

More of the less complex work will be done in smaller hospitals within the group – which could see the patient eventually treated in a different hospital to the one to which they were originally referred. The 'money follows the patient' dictum only applies to inpatient and daycare procedures, and will not affect outpatient clinics or people waiting to see a consultant.

"The system will provide a fairer and more transparent basis for funding hospital services. It will drive greater efficiency in the delivery of services and will ultimately support the provision of quality care in the more appropriate setting," said Dr Reilly.

He also said the long-delayed legislation which will allow free GP care for people with long-term illnesses will be published before the end of this Dail term.

A document published by the department said a recent pilot project testing the system was put in place in orthopaedics.

"There was a two day reduction in the average length of stay and a 45pc increase in day-of-surgery admission rates, while not raising any quality concerns."

The 'money follows the patient' method is seen as a stepping stone to universal healthcare insurance, due for introduction in 2016.

Under the scheme, everyone will be insured, either paying their own premiums or having them paid for fully or subsidised by the State.

It promises to end the two-tier system of public and private care which currently exists, but the Government has indicated that it will take two terms before it is extended to everyone.


Although a document setting out the background work was published yesterday, it is still unclear how much it will cost.

Hospitals will still receive some block funding for areas where the 'money follows the patient' model would be impractical.

Department of Health officials said safeguards will be built in to prevent hospitals carrying out unnecessary procedures to boost their funding.

The eventual aim is to extend this system to services provided outside hospital, and to move away from block funding.

Irish Independent

Promoted Links

Today's news headlines, directly to your inbox every morning.

Promoted Links

Editor's Choice

Also in Irish News