HSE overspend stands at €170m

nursextreme

http://www.rte.ie/news/2011/0715/health.html

HSE Reports an overspend of €170million for first half of 2011

Hospital overspending accounts for €120m of this figure, with the overspend at the Mid-Western Regional Hospital in Limerick over €14m alone.
Waiting lists for children and adults have also increased to over 54,700.
These figures show the scale of the crisis facing the HSE less than half way into 2011.
The HSE says it now has to freeze all but critical vacancies, in order to deal with the escalating pay costs.
Other hospitals that have heavily overspent are: University College Hospital Galway by over €8.5m, Tallaght Hospital by over €7.5m, Cork University Hospital over €7m, St Vincent's in Dublin over €6m and Our Lady of Lourdes in Drogheda and Beaumont Hospital by over €5m.
The HSE says that some hospitals will run into serious cash flow problems, if they do not take significant measures to bring down costs in the second half of the year.
The overspending is blamed on several factors, including increased hospital activity and hospitals not recouping charges from public and private patients

nursextreme

I can confirm that a number of Mental Health Nurses who had recently obtained full time posts to but had not started were told that their posts were put on hold indefinitely, they were informed this on Tuesday no real explanation other than the money had run out. A tough 6 months ahead for the Health Service.

Tea drinker

It's bad that the HSE are saying they have to make cuts due to escalating pay costs. In fact it's unfathomable they haven't got control of this after 4+ years of the recession. This is simply inexcusable. Admitedly some of this was under the pandering FF but these latest overruns are on FG bib now.

Nody

Simply sounds as they have no cost control and expect "someone" to pay up even if they go over (as usual). Of course the correct answer would be to put a hard stop of any additional funds going to HSE and making each mid manager and higher have clear budget responsibility. That is never going to happen though as it would bring it far to close to actually having accountability in place...

Nijmegen

The method of funding the HSE is fairly silly, with hospitals given a flat budget and told to make due. The current health minister has said that this is silly. It makes no account for demand. This is where their proposal for money that follows the patient makes a lot of sense.

Add in to that silly funding arrangement a dysfunctional management and you see how they can have cost overruns every year.

Good luck to patients. As one poster said some time back, if you have health difficulties in the future you can call any one of 200,000 permanent administration staff in the government and ask them for advice.

spank_inferno

The reports notes their poor record at collecting fees from patients.

I can echo that.

It seems that the HSE doesn't really bother with any collections/demands for payments.
I know this because I have yet to be asked to pay for a visit to Loughlinstown A&E (I know, a dump) 2 years ago.

I wasn't invoiced at the hospital or later via post.

Nijmegen

spank_inferno wrote: »

The reports notes their poor record at collecting fees from patients.

I can echo that.

It seems that the HSE doesn't really bother with any collections/demands for payments.
I know this because I have yet to be asked to pay for a visit to Loughlinstown A&E (I know, a dump) 2 years ago.

I wasn't invoiced at the hospital or later via post.

This is where 'natural wastage' has an effect - I know a person working in one of our busy hospitals who is now the only person remaining from a previous 5 person accounts team.

spank_inferno

Nijmegen wrote: »

This is where 'natural wastage' has an effect - I know a person working in one of our busy hospitals who is now the only person remaining from a previous 5 person accounts team.

Very valid point.

Would it be worth outsourcing fee collection to a private collections agency?
The cell phone companies pass on outstanding debt collections to a crowd called Intrum Justitia, they in turn hound the customer for payment.

Until the flat rate funding situation ends the Hospitals have to get serious about retrieving monies owed.

murphaph

spank_inferno wrote: »

Very valid point.

Would it be worth outsourcing fee collection to a private collections agency?
The cell phone companies pass on outstanding debt collections to a crowd called Intrum Justitia, they in turn hound the customer for payment.

Until the flat rate funding situation ends the Hospitals have to get serious about retrieving monies owed.

My bro forgot to pay a bill in James' and it was sent to Intrum Justitia, so they already do it apparently.

The point Nijmegen majes is so valid. This natural wastage method of reducing (ahem) the PS wages bill is totally bogus.

We should remove people who aren't needed and offer them redeployment to places they are (if they have the skills!). If they refuse or aren't skilled for a department with urgent vacancies, then they get made redundant, like anywhere else in the real world.

We should reduce all pay again in the PS. Lower paid admin staff are still overpaid compared to the private sector, as are our top consultants compared to their UK counterparts.

We should pay people in the PS based on individual performance. NO collective bargaining for slackers to hide behind. Good, hard working staff should be paid a premium to keep them in the PS!

We should then HIRE people into the PS where required, having rid ourselves of the dead wood.

Nijmegen

spank_inferno wrote: »

Very valid point.

Would it be worth outsourcing fee collection to a private collections agency?
The cell phone companies pass on outstanding debt collections to a crowd called Intrum Justitia, they in turn hound the customer for payment.

Until the flat rate funding situation ends the Hospitals have to get serious about retrieving monies owed.

Debt collection agencies hounding people who haven't been correctly invoiced would be told to bugger off. Fix the billing problem in the HSE first, by introducing a dynamic and functional administration (ha. ha. ha.)

stevenmu

How the hell have they got rising staff costs when they've been cutting services and are so stuck for junior doctors that they have to import them.

nursextreme

Limerick Regional Hospital is running the highest budget over run at €14m, looking at Healthstat figures for the same:
http://www.hse.ie/eng/staff/Healthstat/hospitalresults/dooradoyle/

Year to date actual expenditure was 26% above budgeted expenditure, payroll expenditure accounting for approx two thirds. It doesn't give figures for patient numbers which would have been useful in ascertaining whether or not the overspend was reflected in a similar rise in patient numbers.

mikemac

Limerick Regional now has to deal with extra since Nenagh and Ennis were downgraded but with no extra resources or expansions.
Not surprised at all they've gone overbudget if they were working on the old estimates

As for the HSE, it was widely reported last year they have over 2,000 people in HR. A crazy number and most are not needed if you put in a good central system.
Why can't some be transferred to Department of Social Protection to do administration and clear backlogs, they are needed over there.
I thought the Croke Park agreement dealt with issues like this

But natural wastage means some departments are understaffed, probably the busiest and most stressful as good people leave.
But the easier jobs may end up overstaffed. No disrespect to HR of course.
It's the worst possible way to reduce headcount. And it's usually the youngest and most ambitious staff who leave, not the dead wood

Welease

mikemac wrote: »

Limerick Regional now has to deal with extra since Nenagh and Ennis were downgraded but with no extra resources or expansions.
Not surprised at all they've gone overbudget if they were working on the old estimates

One would assume that if there was a proper plan in place <cough> the savings by the rationalisation of services in Nenagh and Ennis would have been transferred to Limerick regional to (at a minimum) make those changes cost neutral?

nesf

Welease wrote: »

One would assume that if there was a proper plan in place <cough> the savings by the rationalisation of services in Nenagh and Ennis would have been transferred to Limerick regional to (at a minimum) make those changes cost neutral?

lol, good one.

Sleepy

Is anyone else surprised that the overspend is only in the millions?

Tea drinker

Sleepy wrote: »

Is anyone else surprised that the overspend is only in the millions?

You are so used to it being worse it just sounds okay.... 170 million is really bad news, only half way throught the year yet, and they are blaming it on escalating pay costs meaning the existing costs will be paid for the rest of the year (so 340 million ) it will get worse due to the escalating wording used, so guess at 500 million?

escalating wage costs my firm rump.

thebman

How are wage costs rising when there is a pay freeze and a hiring freeze?

I think the HSE is our version of most Greek departments who apparently when the IMF went in knew what the budget they were allocated was but couldn't tell the IMF how much they had actually spent.

Money has been thrown at the Health problem for so long, I wouldn't be surprised if this culture had developed of not keeping track of the bills.

nursextreme

thebman wrote: »

How are wage costs rising when there is a pay freeze and a hiring freeze?

The HSE should explain in detail why the payroll costs are escalating, otherwise we may assume that if staff ceilings have not increased and pay scales have not increased then another payroll cost must account for the increase.

Nijmegen

One might assume that agency staff are being employed to make up for those lost to wastage?

Untargeted redundancy rears its retarded head again.

Chucky the tree

spank_inferno wrote: »

The reports notes their poor record at collecting fees from patients.

I can echo that.

It seems that the HSE doesn't really bother with any collections/demands for payments.
I know this because I have yet to be asked to pay for a visit to Loughlinstown A&E (I know, a dump) 2 years ago.

I wasn't invoiced at the hospital or later via post.

Why do you need to be asked? No wonder the health service is in such a mess. :rolleyes:

Chucky the tree

Chucky the tree wrote: »

Why do you need to be asked? No wonder the health service is in such a mess. :rolleyes:

People also get very irritated when actually asked to pay their bill:

http://www.boards.ie/vbulletin/showpost.php?p=71488012&postcount=1

Sleepy

Tea drinker wrote: »

You are so used to it being worse it just sounds okay.... 170 million is really bad news, only half way throught the year yet, and they are blaming it on escalating pay costs meaning the existing costs will be paid for the rest of the year (so 340 million ) it will get worse due to the escalating wording used, so guess at 500 million?

escalating wage costs my firm rump.

Oh, I get that. More pointing out how de-sensitized to the figures I've become that it's "only" 170 million euro...

Edgar Eats

minimum of 5% cuts to all hospitals again next year
will prob be as high as 8% for certain services

Edgar Eats

nursextreme wrote: »

The HSE should explain in detail why the payroll costs are escalating, otherwise we may assume that if staff ceilings have not increased and pay scales have not increased then another payroll cost must account for the increase.

are you familiar with the croke park agreement?
take a look at it

nursextreme

Nijmegen wrote: »

One might assume that agency staff are being employed to make up for those lost to wastage?

A good chunk of overtime also just for good measure.

tweedledee

is it any wonder??
http://www.irishexaminer.com/ireland/hse-pays-its-chairmans-firm-325k-161394.html

motherriley

HSE are paying out too much for unnecessary anti psychotic drugs for elderly people in care homes to keep them quite and they do not need them.

When are people going to realise that this it is not right to treat elderly people like this. :mad:

http://www.bbc.co.uk/news/health-14138884?postId=109716041#comment_109716041

thebman

tweedledee wrote: »

is it any wonder??
http://www.irishexaminer.com/ireland/hse-pays-its-chairmans-firm-325k-161394.html

:eek: Surely that is abuse of his position?

He should not be able to outsource to his own company unless he can demonstrate the process where by the company was the cheapest offer and best service. In any case, he should have removed himself from the decision making if he had an invested interest.

Government should demand he step down immediately TBH.

Shelflife

Theres simply no accountability at management and senior management level.

There are seemingly no consequences for management at any level who are simply not up to the job.

nesf

thebman wrote: »

:eek: Surely that is abuse of his position?

He should not be able to outsource to his own company unless he can demonstrate the process where by the company was the cheapest offer and best service. In any case, he should have removed himself from the decision making if he had an invested interest.

Government should demand he step down immediately TBH.

From the article the company had the contract before he was made chair of the HSE. It was disclosed etc. Looks terrible though and makes for an awful headline.

tweedledee

I have several good friends who are in office posts in the HSE,one is a consultant doctor in Limerick.All of them will tell you that nobody,NOBODY ever asks any questions or makes any reports on colleagues.
Structure wise nothing at all has changed in the general running of HSE,there are less funds available but at a management level its samo samo,spend spend spend.No questions asked.

Edgar Eats

tweedledee wrote: »

Structure wise nothing at all has changed in the general running of HSE,there are less funds available but at a management level its samo samo,spend spend spend.No questions asked.

that is a very ill-informed view I must say
obviously there are huge issues to be solved
to say nothing has changed is not true though

tweedledee

Whats changed???????
The HSE are spending millions of taxpayers money on Contract Employees(Doctors,nurses etc) because of the moratorium on front line recruitment.Just like the Garda ban on recruitment,its costing the state more money by NOT recruiting???
I wonder who owns the "private" companies supplying these "contract" employees?????:mad:

Edgar Eats

do you honestly think we need to recruit more nurses?

nursextreme

Edgar Eats wrote: »

do you honestly think we need to recruit more nurses?

Yes!, if it means not paying agency fees or overtime rates to make up the man hours needed, more logical to pay new staff (-10% that new entrants are subject to) at the lower end of the scale if needs be.

nursextreme

Edgar Eats wrote: »

are you familiar with the croke park agreement?
take a look at it

I never saw the section where it outlined that any saving that could be made in reducing staff numbers could be spent on Overtime and Agency workers.

Edgar Eats

recruiting nurses when we have far too many already doesn't really make much sense to me
work practices need to be changed in the public system
many "nurses" coasting along, changing the odd bedpan every few hours - ridiculous in my opinion considering the amount of investment put into their training and cpd

more doctors certainly, and ahps

whatdoicare

Not surprised by this really- the amount of wastage is unreal!
I personally know of a healthcare nurse who has worked maybe a total of four months in the last five years since I've known her, yet her job is still there no matter what. She goes in and works the bare minimum needed to get holiday and sick pay then gets her doctor to sign her off as sick. In the private sector she'd have been let go long ago! Her coworkers are all in on this too and regularly take sick leave. Why are they all kept on?? Temporary nurses have to be taken on to cover them or else the people they're supposed to be caring for go without. So that's two people paid for the price of one.

This is pure wastage for the sake of wastage.

Edgar Eats

the intro of HCAs (with minimum training) could prob replace up to 40% of nursing staff with one stroke of a pen

nursextreme

Edgar Eats wrote: »

the intro of HCAs (with minimum training) could prob replace up to 40% of nursing staff with one stroke of a pen

We already have HCAs in most areas of the Health Service, some services do not but will in the future I would expect, no real problem with that. What you are not taking into consideration is the fact that HCAs cost money too and significantly not much less than nurses at the lower end of the pay scale. That stroke of the pen may not get you the savings you expect, the real issue is the money being wasted on overtime pay and agency fees when the country cant even afford basic wages.