Paudge Connolly (Cavan-Monaghan, Independent)
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Question 258: To ask the Tánaiste and Minister for Health and Children if special consideration will be given in the application of the casemix incentivisation scheme to hospitals experiencing unique service difficulties when funding is being allocated based on previous years' casemix criteria; and if she will make a statement on the matter. [3235/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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All the hospitals which participate in the national casemix programme are actively encouraged to make submissions on issues of concern to them to the casemix technical group in my Department, which is involved in the management of the programme. No restrictions apply to the type of submission they may make. It could be a general issue affecting both their hospital and all hospitals or it could be a unique local issue. Local unique issues could be related to general matters, such as service difficulties, or to a patient whose care was unique or unusual, the cost of which was considerably in excess of the norm. Costs relating to matters which might reasonably be considered beyond local management control are allowed.

The casemix group operates what is termed a "data driven decision making process", that is, any decisions taken are based on real data submitted. The programme is operated in an open and inclusive manner, with all the data being shared among all the participating hospitals. Consequently, the decision to grant a special deduction is only taken where it can reasonably be considered valid, beyond local management's control and can be justified to all other participating hospitals.

Casemix adjustments are only part of the financial allocation process and specific to the year in question, nor are they on a cumulative basis as the process starts afresh each year. All the management data is regenerated, based on both the hospital's activity and costs and that of all other hospitals involved in the programme. The lessons learned from the previous casemix budget are carried forward and changes which have occurred, be they clinical, financial or management, are reviewed. Cost per case, length of stay and changing clinical practice data, such as the introduction of medical assessment units, are all reviewed and incorporated into the new budget model.

The activity and costs for a given year are reviewed vis-À-vis their peer group, resulting in hospitals being funded for the patients they actually treated, including exceptionally high cost or long stay patients. Any issues beyond the remit of case mix can be addressed directly with the National Hospitals Office and the Health Service Executive.