David Cullinane (Waterford, Sinn Fein)
Link to this: Individually | In context

521. To ask the Minister for Health if she will outline plans to reduce dependency on insourcing and outsourcing care to reduce waiting lists; if a multi-annual plan exists to achieve same; and if she will make a statement on the matter. [31462/25]

David Cullinane (Waterford, Sinn Fein)
Link to this: Individually | In context

522. To ask the Minister for Health the steps she has taken to manage conflicts of interest in relation to the insourcing of care at public hospitals; and if she will make a statement on the matter. [31463/25]

David Cullinane (Waterford, Sinn Fein)
Link to this: Individually | In context

524. To ask the Minister for Health if she has identified any potential perverse incentives in relation to the insourcing and outsourcing of care to manage waiting lists; and if she will make a statement on the matter. [31465/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
Link to this: Individually | In context

I propose to take Questions Nos. 521, 522 and 524 together.

I acknowledge that many patients are still waiting too long to access hospital care, and I am conscious of the burden that this places on them and their families.

I published the Waiting List Action Plan (WLAP) for 2025 on February 12th, representing the Government’s commitment to reducing waiting times for patients and improving access to hospital care.

With the 2025 plan, we are continuing to build upon the progress delivered to date under the multi annual action plan approach, progressing towards the ultimate vision of a public healthcare service in which everyone has timely access to high-quality scheduled care, where and when they need it.

This Government remains committed to increasing capacity in the public system and until that capacity is in place to meet the increased levels of demand, it’s appropriate that we make use of all available additional capacity in the public and private systems to ensure that patients have access to the care they need.

Accordingly, the Waiting List Action Plan approach includes targeting the delivery of additional capacity for patients in the public and private systems, through a coordinated approach by the HSE and the National Treatment Purchase Fund.

NTPF Insourcing initiatives are governed by a Memorandum of Understanding (MOU) between the NTPF and the relevant public hospital. Under the MOU, the public hospital confirms that any such work is additional work over and above core hospital activity and is specifically carried out to reduce waiting lists. All governance for insourcing remains with the public hospital, based on specific treatment plans where a need is identified and a solution available. All work is approved at the appropriate senior level.

The NTPF also sources treatment and appointments for patients through outsourcing arrangements with Private Hospitals. This is done through a Panel Agreement established following a competitive tender competition. As with insourcing initiatives, while the NTPF identifies patients eligible for treatment the clinical suitability is determined by the public hospital. The payment to the private hospital is based on a tendered price for the relevant procedure, and all payments to Consultants are a matter for the Private Hospitals.

In April, at my request, the HSE CEO initiated a detailed survey of all insourcing activity within the HSE, which will be assisted by Finance, Internal Audit, HR and Access/Integration functions. Insourcing can be funded either directly by the HSE/hospital concerned, or by the NTPF. This nationwide review is underway, and the HSE CEO has taken certain precautionary steps in the interim to further reduce the risks of conflicts of interest and other concerns that might arise.

The Department of Health worked closely with the HSE and the NTPF to develop the specific actions and targets set out in this year’s WLAP. The WLAP 2025 has further measures beyond insourcing and outsourcing to address waiting list issues and sets out 25 actions under the themes of “Delivering Capacity”, “Enabling Scheduled Care Reform” and “Reforming Scheduled Care”. In this way, we aim to reduce our reliance on insourcing and outsourcing and continue to build a public hospital system in which everyone can receive care in a timely fashion.