Underperforming hospital managers and consultants 'targeted'
Cork Is University Among Picture: Linehan Out The Singled As Dan Hospital 'problematic' Hospitals
Underperforming consultants and managers in some of the country's worst hospitals have been “targeted” in recent weeks and asked to account for their failures.
Government ministers, angered by a lack of progress in a number of hospitals, including Cork University Hospital (CUH) and University Hospital Limerick (UHL), have blamed managers for the poor performance, amid record levels of overcrowding and long waiting lists.
Under mounting political pressure at a time of a record €23bn spend on health, ministers say the managers are “unable or unwilling” to deliver.
As the country is plunged into winter, the Cabinet is deeply concerned as to the capacity of the underperforming hospitals to properly manage their resources in the weeks ahead.
Using new performance-tracking data, Health Minister Stephen Donnelly and his officials have been touring some of the worst hospitals and speaking directly to managers as to why problems are not being resolved.
This new performance-management system allows access, for the first time, to detailed operational information that can be used to hold hospitals and individual consultants to account.
Senior Government sources have said that a number of major hospitals are performing well and delivering efficient care to patients, but others are "quite poor on many fronts".
Among the hospitals singled out by ministers as “problematic” are University Hospital Galway, UHL, and CUH.
Part of the problem being flagged for the poor delivery is the “quality" of management teams, both clinical and non-clinical.
Mr Donnelly has said that he believes new Regional Health Area chiefs should be paid in line with new consultant contract and that hospital CEO salaries should be higher in recognition of greater accountability. Sources have said that the new consultants’ contract is likely to give hospital CEOs a greater power over the doctors under them, but this is the subject of tense talks at present, with consultants keen to retain their autonomy.
Another major reason for poor performance is the lack of physical assets available, such as beds, theatres, diagnostics, car parking, and an inconsistency of modern working conditions across specialities.
The current difficulty in attracting and retaining staff has also been identified as a factor as some areas of the country are finding it much harder to recruit and cannot attract or keep the best people.
In meetings with management, it is understood that Mr Donnelly has agreed that the process for approving new building at hospitals is too time-consuming and the recruitment process is far too slow generally.
He has also accepted that in HSE hospitals there is an absence of local autonomy and hospital managers have no “proper oversight or control” over the actions of consultants, even those performing poorly.
Following on from the HSE hacking last year, Mr Donnelly has accepted that IT systems in hospitals are “generally not fit for purpose”.
The number of people on trolleys waiting for a hospital bed has hit an all-time record. There were 669 people, including 28 children, on trolleys across the country two weeks ago. Of the total number, there were 72 people without a bed in CUH and 80 in UHL. They have consistently been the worst performers in terms of people on trolleys for a number of months.
It emerged last week that more than 100,000 patients have gone without beds in hospitals so far this year, with more than 1,903 children left waiting on trolleys.
The Irish Nurses and Midwives Organisation has called for the Government to bring in measures needed to retain nurses and midwives to help address the crisis.