HSE West could be €100 million over budget by December

A member of the HSE West’s regional health forum warned this week that the health authority could be €100 million over budget by the end of the year.

Fianna Fail councillor Mary Hoade was commenting after it was revealed that the local HSE had overspent by €34m as of the end of April.

The Headford county councillor told a meeting of the forum that the fact that it had exceeded its €649m budget by 7.7 per cent this early in the year was of major concern.

“It is very worrying to see this. We are only one third of the way into the year and we are €34.6m in excess of our budget. We could be €100m in excess of it by the end of the year.”

The meeting, held at Merlin Park Hospital on Tuesday, heard that the overspend occurred across all areas. The hospitals accounted for most of the deficit (€31m ).

The main categories over were drugs and medicines, medical and surgical supplies, professional services, heat, power and light. There were savings made on office expenses, miscellaneous and grants.

Liam Minihan, the HSE West’s assistant national director of finance, outlined that the authority was facing a “challenging remaining period”.

He explained that private health insurers owed the HSE West about €12m. The biggest problem, he said, was getting some consultants to sign claim forms. This led to a backlog of claims not being submitted to the insurance companies. He said the clinical director for acute and continuing care in Galway and Roscommon will be “speeding up this process”.

He outlined that a major income collection project is under way in acute hospitals focused on three areas - the backlog of claims not yet submitted to the insurance companies due to the absence of consultants’ signatures, claims pended by these companies for various reasons, and making better use of private bed resources. He said local cost containment plans are also being implemented.

Cllr Hoade said the forum had been listening for two years about the backlog of health insurance claims and feared the authority would be in deeper financial trouble down the line.

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Other forum members wondered which health services would suffer because of the overspend and if progress was being made in relation to the claims backlog.

Forum chairperson Cllr Padraig Conneely said he was “alarmed” that in the first four months of 2011 the HSE West was €34m over budget.

It was “very disappointing” to see the Galway/Roscommon area had a €12m budget overrun, he added. He was highly critical of the delays caused by some consultants’ failure to sign private health insurance claims saying the HSE was “going nowhere” in this regard.

He stated it was “beyond belief” that consultants on salaries of €230,000 a year would not put their signatures to forms, thus allowing the HSE to claim money from private health insurers. He claimed many of these consultants would be “very quick” to put their signature to claim forms for private patients. He asked what action the health authority could take to tackle this issue which was a “non-runner” and had been debated for three years.

John Hennessy, the HSE West’s regional director of operations, said this matter was not as simple as consultants just signing their names to forms. They had to certify the content of the claim and this takes time.

Referring to the budget overrun he said the high expenditure in the first quarter of the year reflects the activity over the winter period - the pressure on acute hospitals and community services. He said the authority is seeing a pattern of high expenditure from January to April but there is a tendency for this position to recover over the summer period before coming under pressure again from October.

He stated the budget overrun is of “huge concern” and stressed there was no provision for an overspend in 2011. He said the issue is being dealt with in a “balanced and measured way” which will protect frontline services.

He took issue with Cllr Conneely’s claim that the HSE was going nowhere in relation to following up on the private health insurance claims. He said he had seen “ample evidence”of the consultants’ commitment to this and added they were as keen in most cases as HSE management to maximise income collections from private health insurers.

Dr David O’Keeffe, the clinical director for acute and continuing care in Galway and Roscommon, said the claim forms issue was being addressed and there had been some improvement in the last six months. He reiterated that the forms were complicated and said HSE management was using its “persuasive powers” to encourage consultants to speed up the process.

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