The Government acknowledges that acute hospital waiting lists are too long, and many patients are waiting an unacceptably long time for care.
We are committed to improving access to hospital care, through reforms and by building sustainable internal capacity within the public system and ensure that this is maximised to the greatest extent through greater productivity and efficiencies.
Until that capacity is in place to meet the increased demand, we need to utilise all available options in the public and private systems to ensure that patients have access to the care they need. However, I firmly believe that we are overly reliant on insourcing and private sector outsourcing to deal with our waiting lists.
Given my concerns about the operation of the insourcing model in particular, earlier this year I asked the CEO of the HSE to conduct a review of insourcing and outsourcing. Having considered the review with my officials and the HSE, I wrote to the CEO in August authorising him to introduce a number of control measures to restrict the use of third-party insourcing. We need to move away from our dependency on this model to fully use the internal underutilised capacity we have within our core health service and this means that productivity in the HSE itself must improve and we are taking action to address this, including through the full implementation of the Public Only Consultant Contract (the POCC) for:
• more efficient rostering of services across 6/7 days;
• better scheduling of outpatients to maximise existing resource utilization;
• improved benchmarking and standardisation of scheduled care;
• maximising physical assets such as diagnostics, surgical hubs, virtual wards where appropriate.
Given the time lag in these productivity measures impacting on scheduled care performance, I approved a recommendation in the CEO’s report that the HSE engage with the NTPF and private providers, including non-hospital providers, to develop an expanded framework to outsource scheduled care work once all core capacity has been utilised.
In addition, to ensure patient have access to the treatments they require, 3rd party insourcing can still be used if a derogation from the relevant REO has been granted, all control measures have been complied with and a significant need for a targeted scheduled care initiative has been identified.
