Joan Burton (Dublin West, Labour)
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Question 422: To ask the Tánaiste and Minister for Health and Children the justification for the reported €711,432 fine in January 2006 and for the €1 million fine in 2005 against James Connolly Memorial Hospital; the reason for these fines; the comparative figures for such fines in respect of all years from 1998 to date; and if she will make a statement on the matter. [1835/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Casemix is an internationally accepted evidence-based management system used for the monitoring and evaluation of health services. It allows for the collection, categorisation and interpretation of hospital patient data related to the types of cases treated to assist hospitals define their products, measure their productivity and assess quality. Casemix is used for many purposes related to hospital and health service management as it provides the only audited national data set of patient related information necessary for national planning. With regard to using casemix as part of the budgetary process, this is done so that hospitals are fully funded for the patients they actually treat at a cost per case set by their own peers.

The system reviews each patient treated, having regard to age, sex, diagnoses, procedures, length of stay, mode of discharge, etc. and calculates a cost per case for each patient both in the individual hospital and nationally within the hospital's peer group. The programme allows each hospital to take full account of their unique patients and unique issues. The entire process takes place in consultation with each hospital, placing patient centred information at the heart of the process.

Details of the adjustments for James Connolly Memorial Hospital from 1998 to date are: in 1998, €33,086; in 1999, €76,185; in 2000, €214,654; in 2001, €92,631; in 2002, €84,576; in 2003, €331,370; in 2004, €1,079,638; and in 2005, €1,339,389. The negative adjustments are a reflection of the hospital's true performance vis-á-vis its peers following full compensation for its own unique local circumstances and mix of cases. This year, the negative adjustment fell considerably from €1,330,389 to €711,432 and it is hoped this trend will continue.

The casemix budget model now comprises four separate elements: inpatients; day cases; split-year workload; and, since last year, accident and emergency. Data on inpatients day cases and accident and emergency are for the calendar year under review and the budgetary figures recently released relate to 2004 activity and costs. The split-year workload adjustment reviews inpatient activity from July 2004 to end-June 2005 and is used to focus on the most up-to-date data available and draw hospital management's attention to trends. This year, the hospital actually gained some funding under this portion of the budget. If this trend has been continued throughout 2005, the hospital may have addressed key issues and is moving towards a positive budgetary outcome in the future.