HSE punishes hospitals for overspend

Hospitals and local health areas which overspent their budgets in the first part of the year have been excluded from consideration for millions of euro in development funding allocated by the Health Service Executive (HSE).

The Irish Times has learned that, early in the summer, senior HSE management instructed that hospital networks and local health areas which were more than 5 per cent over their budget, based on financial returns for the first four months of the year, could not receive funding for development projects through its strategic planning and reform initiative, known as Spri.

The aim of the Spri group was to provide funding for innovative projects in addition to the core financial allocation for hospitals and local health areas.

The Spri steering group told HSE chief executive Prof Brendan Drumm last month that a number of projects amounting to €4.491 million were considered to have met the relevant criteria for support but had had to be excluded because the hospitals and health offices concerned had breached the 5 per cent over-spending threshold.

Among proposals which did not receive funding were a pilot programme for the self-management of type II diabetes and a youth sexually-transmitted infection clinic in the south, a GP-based community heart failure service in the west and midlands and a project in the south-east to provide anaesthetic services for children unable to co-operate with dental treatment.

A project to enable the self-administration of immunoglobulin at home, the provision of 200 hours of home nursing services to patients with dementia and a programme to assess the numbers in residential care who could move to supported, independent living were also affected.

Internal HSE documentation reveals deep divisions within the Spri steering group in relation to the instruction to hold back funding from agencies which had exceeded their budgets.

In a memorandum sent to Prof Drumm in early June, the chairwoman of the Spri steering group, Maureen Lynott, said that the director of the National Hospital Office had indicated that he objected to the failure to approve funding for valid proposals.

"The national director for Primary, Community and Continuing Care (PCCC) requests that all of the PCCC proposals in this category proceed on the basis of break-even at area rather than local level given the current clustering of area costs into some local budgets," Ms Lynott wrote.

She said that while there was "some divergence" within the steering group on the issues, the preponderance of the membership were in agreement with the recommendations.

It has emerged in recent weeks that a number of hospitals across the State overspent their budgets significantly in the first few months of the year.

Hospitals in the north-east are understood to have overspent by 22 per cent up to April.

Informed sources said that Tallaght, St Vincent's and the Mater hospitals in Dublin also significantly overran their budgets.

However, the HSE has maintained that there will be no cutbacks on services. The HSE said last night that the Spri group had recommended other development projects, worth €3.69 million, at its meeting in June.

It confirmed that projects in agencies with a financial overrun of more than 5 per cent were not approved for development funding. "This approach enables priority to be given to development projects that are being promoted by hospitals and/or local health offices that are operating within a break-even position and is consistent with the HSE's responsibility to balance its overall budget," it stated.