HSE boss admits new plan unrealistic
Patients face longer delay for treatment, warns health chief
A KEY target of reducing waiting lists to see a hospital consultant to under a year by the end of 2015 will not be met, the boss of the HSE has admitted.
As the Health Service Executive launched its ambitious national service plan for 2015 Tony O'Brien told the Irish Independent that the one-year deadline was not achieveable.
It comes after a bleak analysis of outpatient waiting times by this newspaper showed that one in every eight patients - nearly 50,000 people - is enduring delays of more than a year to get an appointment with a specialist.
The HSE's plan for next year states that the waiting time should be brought below 12 months - but officials have already admitted defeat.
In a very frank response, the HSE's director general said: "At this stage the one-year target looks like a stretched target.
"Our focus in 2015 is to have the longest waiters seen first. We have taken that approach and it has been successful. We also want to reorganise to see a higher proportion of new rather than return patients."
In fact, Mr O'Brien said there is even a possibility that the average waiting time could rise.
The plan, which was launched by Health Minister Leo Varadkar, also sets a target of April 1 for the introduction of free GP care for under-sixes and over-70s.
The HSE is mostly aimimg to maintain the already strained "status quo" with little scope for new developments.
The minister said the €12.13m will have to stretch like the miracle of "loaves and fishes", despite an extra €115m in funding.
Mr O'Brien said senior managers faced new accountability demands in relation to how they delivered targets with the extra funding.
They would be subject to a scoreboard system every month.
The main aim was to "support" them but ultimately they could face a disciplinary hearing, he added.
The "savings" the HSE has to achieve in areas such as drugs and agency staff costs are higher than already flagged.
It will now have to shave another €100m from its spending in 2015, on top of the €130m which was announced on Budget day and this could impact on services.
A series of major challenges facing the HSE were outlined yesterday including the fact the 850 patients - the equivalent of a large hospital - are now occupying scarce beds while waiting for a nursing home place or home care package.
Some €3m funding will be released on December 1 to allow some patients be discharged.
Another €5m is being given to home care packages for an additional 600 people.
The Fair Deal nursing home scheme will get a €10m increase in funding, creating an extra 300 nursing home places. However, it will be January before the waiting list of more than 2,000 for the scheme will start to fall.
The target to have no public patient waiting more than eight months for an operation remains, although latest figures show nearly 9,400 are waiting for longer.
The plan also outlined:
An extra €35m will be invested in community-based mental health services to improve suicide prevention and 24/7 crisis responses.
€100,000 will be spent on extending Breastcheck to older women, beginning late next year. Another €15.1m will be given to oncology services.
A second palliative care consultant will be appointed in the Midlands.
€20m extra is to be given to disability services with more day services for school leavers.
An extra €2m will go to maternity services for more staff.
GPs are to get better access to diagnostics for patients with a small allocation of €1m.
The numbers covered by medical cards will fall from 1.78m to 1.7m.
The plan said the health service would have to manage with 300 fewer staff next year although the cap on headcounts was over. The HSE must cut its bill for agency staff by €140m.
However, hospitals are still struggling with vacancies for around 200 specialists after an improved offer for new recruits was rejected.
Mr Varadkar said that while there was a rise in funding for the first time in seven years he did not want to "over-promise" about 2015.
"We have to be realistic. It is still under-funded and not organised to deliver best value for money." It had been "battered and bruised" by cuts and this was a first step.
He could not rule out the HSE, which needs a bailout of €510m this year, over-spending in 2015. Any over-run would be a first charge on its 2016 funding.