James Reilly (Dublin North, Fine Gael) | Oireachtas source

The Government is undertaking the most extensive reform of the health service since the foundation of the State, particularly in the context of new hospital groups, the small hospital framework and the methodology with which we remunerate hospitals and give them their budgets, that is, moving from a block budget where everything stops once the money is gone. That system further encourages the retention of people in beds when their acute phase of treatment is over. It does not incentivise hospitals to move them on. We want to change it to a money follows the patient system. Even within the insurance market, current arrangements see public and private hospitals charge per day. I want that changed to a money follows the patient system in terms of paying per procedure. Those hospitals that admit patients on the day of their procedures, look after them efficiently and reduce readmissions and the average length of stay will all benefit.

The company in question won the tender, but I insisted that the Department renegotiate the price downwards. That was done. The information is invaluable to us in planning a complete sea change in terms of moving towards UHI. We all acknowledge and accept that, while there is vast experience in the Department and the HSE, we do not have the full range of expertise that we always need. For example, there is a lack of suitably trained individuals within the HSE in the context of financial reporting. This matter was highlighted by Mr. Mark Ogden in his report and confirmed by PA Consulting Group. The latter has made certain recommendations. I hope those reports will be released shortly in order that it can be seen that we have taken action to correct what has been a glaring deficit since the HSE's inception.

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