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Hospitals fail to hit target for day surgeries


Minister for Health Leo Varadkar. Photo: Frank McGrath

Minister for Health Leo Varadkar. Photo: Frank McGrath

Minister for Health Leo Varadkar. Photo: Frank McGrath

A senior management figure at the Department of Health is putting pressure on hospitals to justify keeping patients overnight instead of treating them through day surgery.

Secretary General at the department, Dr Ambrose McLoughlin says the hospitals should be required to show "a clear reason" when they decide to admit patients for procedures "at considerable extra cost".

The health chief was commenting on a special report by the Comptroller and Auditor General on 'Managing Elective Day Surgery'.

The report found that some hospitals were only reaching 50pc of their targets for day surgery while others reached 90pc.

In the case of major Dublin hospitals, Tallaght and St James' fell short of the HSE-set 75pc target while Beaumont, St Vincents, the Mater and Connolly hospitals exceeded the target.

The HSE has calculated that day surgery on average is 60pc cheaper than in-patient treatments.

The HSE has identified 24 elective procedures as suitable for day surgery.

The C&AG recommends that separate targets should be set for each of the 24 procedures.

Included in these: hospitals should ensure there are pre-operative assessments to identify those unsuitable for day surgery.

They should take steps to maximise the use of operating theatres for day cases and nurses - rather than doctors - should be able to discharge day patients using set criteria.

The report also found that an increasing number of minor surgical procedures were being carried out as day surgery instead of at out-patient clinics or GP surgeries.

This was because hospitals did not provide incentives to perform these in "a more appropriate setting" where the costs would be less.

It was estimated that as many as three in five of these day surgery treatments could be more appropriately carried out in other settings at lower cost.

Overall the report says the benefits of day surgery include patients being able to return home on the day of treatment, reduced risk of hospital-acquired infection and reduced pressure on waiting lists.

It says day surgery should be the default option for many common elective treatments unless there is a valid reason for an overnight hospital stay.

The report findings have been welcomed by Health Minister Leo Varadkar who said a move to more day cases should lead to long-term savings.

"Making day surgery the default option for more surgical procedures should increase the number of procedures being carried out and benefit patients by helping to reduce waiting lists," he said.

The report also found that overall hospitals reported that only 10pc of their operating theatres were dedicated to day cases.