Seán Power (Kildare South, Fianna Fail)

It is an indication of the respect in which Deputy Cowley is held that the leader of the Opposition remained in the House to hear his contribution. I thank the Deputy Cowley for raising this matter on the Adjournment.

The national casemix programme compares costs and activity between 37 hospitals that participate in the programme. The programme incorporates over €3 billion of expenditure and 1.6 million patient encounters annually. It allows each hospital to take full account of its unique patients and unique issues. The process takes place in consultation with each hospital, placing patient-centred information at the centre of the process. Casemix was introduced in an effort to collect, categorise and interpret hospital patient data related to the types of cases treated in order that hospitals could define their products, measure their productivity and assess quality.

The rationale for the use of casemix as part of the budgetary process is the wish to base funding on measured costs and activity rather than on less objective systems of resource allocation, that is, to fund hospitals for the cases they actually treat and the service they actually deliver. Casemix creates an incentive for better performance by allowing for peer group comparison and is the most internationally accepted performance related activity programme. I am committed to performance related targets to ensure that hospitals operate at maximum efficiency. The budget-neutral policy of casemix rewards efficiency by re-targeting funds from less efficient hospitals to those which are more efficient and have demonstrated that additional funding will result in real benefits.

The negative adjustment of €613,000 was consequently a reflection of Mayo General Hospital's performance vis-À-vis its peers. The hospital gained funding under the programme in ten of the 13 years in which it has been in operation. No objection to the use of casemix was lodged in those years. The programme is operated in an open and transparent fashion and full details of the clinical and financial information on which casemix budget adjustments are based is provided to all participating hospitals. I am committed to the ongoing expansion of the national casemix programme involving my Department and the Health Service Executive to ensure that casemix is used as a central pillar in hospital funding policy.

See this speech in context