HSE spent up to €180 million on management consultants last year, TDs told

The Health Service Executive spent up to €180 million on management consultancy services last year, according to its chief executive.

Acknowledging that the estimated spend of €120-180 million on outside consultants was extraordinary, Bernard Gloster, who took up his present role in March, told TDs that the dependency on outside advice would have to be reduced quickly.

Cork University Hospital alone paid more than €600,000 between October and December last year to PwC Consultants to help transform hospital services in the city, it emerged this week.

Health staff are being asked to volunteer to work over the coming bank holiday weekend to help alleviate overcrowding, Mr Gloster told the Oireachtas health committee on Wednesday.

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HSE managers are writing to staff asking them to change their deployment arrangements to cover the Saturday, Sunday and Monday of the weekend, he said, similar to the initiative undertaken during the height of winter overcrowding in hospitals last January.

The service was “badly caught out” over the May bank holiday, he told TDs.

While he was not in a position to change current staff contracts, he said his aim was that future contracts would provide for five days of work over the seven days of the week in all disciplines, and not just between Monday and Friday.

“The system doesn’t function on Saturday and Sunday the way it should,” he said.

This would require negotiation as well as additional staff, he acknowledged. If the health service doesn’t move from on-call working to “actual service provision” at weekends, it will continue to have “serious problems” every Tuesday.

Mr Gloster confirmed the traditional HSE winter plan has been “shelved” to be replaced by a year-round approach to be published shortly, as well as a three-year approach to planning scheduled care.

[ Consultants’ opposition to new contracts about more than money and working hours ]

Emergency department attendances are up 10 per cent so far this year compared with before the Covid pandemic, and referrals to hospitals are at an all-time high, he said.

The average number of delayed discharges of patients from hospitals has fallen now to about 500, from 600 earlier in the year. Mr Gloster said community intervention teams are now available to see residents in nursing homes, whereas previously the residents would only have had access to nursing home staff and, sometimes, a GP.

In St Vincent’s hospital in Dublin, for example, community staff are visiting residents in local nursing homes who might require hospitalisation. Just 9 per cent of visits result in a hospital admission, he pointed out.