Oireachtas Joint and Select Committees

Thursday, 22 October 2015

Public Accounts Committee

Health Service Executive Financial Statements 2014
2014 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 39: Health Service Executive
Chapter 19: Compliance with Prompt Payment Legislation in the Health Sector
Chapter 20: Management of Private Patient Income in the Health Sector
Chapter 21: Control over the Supply of High-Tech Drugs and Medicines

10:00 am

Mr. Stephen Mulvany:

Very briefly, if one thinks of the total amount of money involved, the first thing to say is that we start counting the money outstanding from the day the patient is discharged. As such, there is a certain amount of the €290 million which one would expect to see. Given the complexity of the bills, we would expect it to take 13 or so days to issue that bill and the insurer should have about 30 days to pay it. As such, approximately 60 of what I think is 184 or 186 days would be the norm. Everything beyond that, which is by far the biggest part of it, is unacceptable to us. If one looks at the four components of that, there is an administrative piece where we are filling out the form before we bring it to the consultant to sign. That piece, we have, in fairness, steadily improved to reduce the amount of days . We measure this in debtor days, the number of days, so we can compare hospitals. That is because the picture across hospitals is very variable. We have steadily reduced that to the stage where our target is 15 days for all of that administrative processing. The actual average in 2014 was 16 days. The introduction of the claim assure system, which we can talk about more if the Deputy wishes, has assisted us significantly in that respect. The second piece is the time spent for our own consultants to review and fill out the second part of the form, which is the clinical part, and sign off. That piece has got worse and is continuing to get worse, which is a significant problem for us.