Minister for Health Stephen Donnelly is employing a novel methodology to boost productivity and efficiency in the health sector by linking new consultant post funds to existing consultant performances. This new mandate, which will kick in next year, expects existing consultants to match their counterparts at other facilities in terms of the number of outpatients seen. The strategy aims to encourage hospitals to expedite reforms and establish efficiency measures that would reduce outpatient waiting lists.
However, the backdrop of steadily escalating outpatient waiting lists and soaring system-wide costs illuminates the pressing need for this approach. More than 400,000 individuals now wait in excess of the 10-week objective for outpatient appointments. In addition to the €22.5 billion sanctioned in the budget, the government has been forced to allocate an extra €1.5 billion in health funds this year, and a further €1.2 billion has been set aside in next year’s budget simply to uphold existing services.
Given the lack of sustainability of the current state of affairs, innovative strategies are essential. The idea of tying investment to pre-existing performance may seem appealing on the surface. Minister Donnelly posits that the average number of outpatients seen per consultant in hospitals has reduced by nearly 30% since 2016. He asserts that, had the outpatient activity per consultant in acute hospitals last year mirrored that of 2016, an additional 1.4 million appointments could have occurred.
The Irish Medical Organisation, which acts as representatives for hospital doctors, swiftly pointed out a primary flaw in this approach – the challenge of comparing different hospitals. A multitude of factors they cited as potentially impacting consultant productivity, include access to clinics, treatment complexity, and availability of diagnostics, beds and theatres. Even though the IMO might be anticipated to make such contentions, a persisting issue indeed remains – the appropriateness of using a simplistic criterion to determine allocation of investment.
The ethical and clinical dilemmas prevalent in healthcare management today include the distribution of funding. Often, this funding is allocated to hospitals that generate better statistics, rather than those in greater demand. This could cultivate an environment where the emphasis is more on patient count than the quality of care offered.
It would be a challenging venture to design a method for evaluating consultant effectiveness that accounts for all these differing factors. Despite Donnelly’s proposition of a narrowly-focused approach being appealing in its simplicity, it might not yield the anticipated result. This is a component of a broader narrative of rapidly escalating healthcare expenditures generating inconsistent outcomes while appearing to neglect important concerns.
Rapid population growth and increasing cost of medical procedures contribute to this, but establishing enhanced value for money remains a pivotal issue.