The number of Saturday outpatient appointments at Children’s Health Ireland (CHI) Crumlin has increased by more than 240 per cent over the past four years, new figures show.
The hospital group said a “high proportion” of Saturday clinics are funded by the National Treatment Purchase Fund (NTPF).
Concerns have been raised in recent months about overreliance on the fund as well as potential mismanagement of public money.
According to data provided to Sinn Féin health spokesman David Cullinane in response to a parliamentary question, there were 419 Saturday outpatient clinics in Crumlin hospital in 2021, rising to 1,426 last year – an increase of 240 per cent. A total of 742 such Saturday appointments were carried out in the first five months of this year.
READ MORE
By comparison, Temple Street children’s hospital in north Dublin conducted 177 Saturday outpatient appointments in 2024.
[ NTPF suspends special funding at CHI over controversyOpens in new window ]
The figures come following recent controversy at CHI Crumlin after a 2022 internal review, highlighted concerns about the necessity of some weekend clinics for which one consultant had received more than €35,000 in fees.
Following the leaking of that report to media, the NTPF temporarily suspended funding for the children’s hospital group, while the HSE referred the review to gardaí.
Mr Cullinane described the figures as an “unusually high increase”.
“We have to look at productivity Monday to Friday. We need to look at whether there’s a perverse incentive – I’m not saying that’s the case here – but this Saturday work has to be done on the basis of contracted hours and not at an increasing cost to the public purse,” he said.
In response, a spokesman said additional consultant-led clinics at weekends are “part of CHI’s efforts to improve access and shorten wait times”.
“The NTPF is the main funding source in 2025 for initiatives to increase outpatient activity. A high proportion of Saturday outpatient clinics are NTPF-funded, based on approved initiatives aimed at reducing waiting times,” the spokesman said.
In a 33-page report to the Public Accounts Committee, CHI said it had received €8.655 million from the NTPF since 2020 and €28.239 million under the HSE’s access to care initiatives to tackle waiting lists.
Ahead of CHI appearing before the committee on Thursday, the report submitted to politicians said its board was “advised that there was engagement with the NTPF by the Children’s Health Ireland executive” following the 2022 internal review.
However, the report said the NTPF had been engaged in 2021 in relation to compliance with its procedures for waiting list management.
As a result of this, the report states the NTPF were “not specifically engaged with on this specific matter” due to previous audits taking place at the same time as the unpublished report.
Concerns have been raised about the reliance of the health system on the NTPF which was set up some 20 years ago to tackle waiting lists through the use of private hospitals or the use of public facilities outside of core working hours – a process called insourcing.
Minister for Health Jennifer Carroll MacNeill had requested Bernard Gloster, chief executive of the HSE, to conduct an analysis of the use of NTPF funding.
The report is now with the Minister who has called for a move away from paying public staff for out-of-hours clinics.
At the Oireachtas health committee on Wednesday, Mr Gloster is expected to say there is now an “over reliance” on insourcing to supplement core activity.
Over a 27-month period, from 2023 until the first quarter of this year, a “rounded figure” of €100 million has been used on insourcing in acute settings, Mr Gloster will tell politicians.
