HSE managers warned of risks to patients from funding cuts and understaffing

Health Service Executive managers have warned of high risks to patient safety as a result of understaffing and spending cuts across key areas of the health service, internal records show.

The executive’s confidential “corporate risk register” provides an insight into the most urgent challenges facing the organisation as it tries to cope with fewer employees and increased demand for services.

The register, seen by The Irish Times, shows the greatest risks facing the executive over the past year. They include:

Harm to patients arising from inadequate delivery of vital health services linked to understaffing;

Funding running out for the nursing home support scheme, causing knock-on problems across the health services;

Unsafe services for children due to a failure to comply with childcare regulations and standards; and

Risk of vaccine-preventable disease, such as measles, occurring due to failure to achieve targets for vaccine uptake.

The troika
Under pressure from the troika over health costs, the HSE budget has been cut by more than 20 per cent, or €3 billion, since the financial crisis began in 2008.

It has also lost more than 11,000 employees over the same period. This year the HSE faces another steep budget cut, although its service plan pledges to deliver the “maximum level of safe services possible”.

However, a detailed breakdown of risks facing individual services across the HSE shows elevated concern over the safety of cancer care for thousands of patients.

Highest risk
One of the highest risk ratings is linked to not having sufficient staff that are "essential to ensure adherence to quality control and quality assurance strategies" across cancer services.

There is also concern that designated cancer centres may fail to meet basic standards or targets for speedy delivery of care due to “fiscal challenges, the recruitment moratorium and other priorities”.

The HSE was not in a position to comment on the register last night, but the documents show it has drafted action plans for all risks identified.

For example, in areas such as patient safety, the register states there is a stronger focus on clinical care through the appointment of clinical directors, healthcare audits and training.

The risk register – a common tool across large firms – measures the greatest threats facing an organisation and ranks them in terms of impact and likelihood of occurring.

Fianna Fáil health spokesman Billy Kelleher has described warnings of high risks to patients as a result of understaffing and spending cuts as “frightening but not surprising”.

He said the revelations confirm what his party has been saying “about the high risk to public safety arising from Minister James Reilly’s handling of the health service”.

“[IT] is a damning indictment of Government policy and will cause huge amounts of anxiety amongst patients and their families,” he said.

The TD for Cork north-central called on the Health Minister to “urgently” clarify how these concerns are going to be addressed.

“This will impact on every family in Ireland,” he said. “Minster Reilly needs to urgently change his priorities and focus on frontline services to patients, which he has failed abysmally to do.”