Irish Apartheid. Healthcare Inequality in Ireland now published

My first book has been published. You can get it in all good Irish book shops and on line from New Island www.newisland.ie and  from Amazon.
Happy reading

Sara

My fantasy health budget

The week began with Mary Harney saying that she and her Department are “looking at everything in the health service” in terms of cuts. That for the first time they “are looking at prescription charges, that a 50 cent charge may be imposed per item prescribed”. Instead of hitting the poor and the sick, here are some other political and economic choices that can be made…

40% of hospital population malnourished

Malnourishment is not a feature of modern Irish life that we hear much about. And although deficits in hospital care are regularly highlighted, the food you eat or don’t eat while in hospitals is not one of them. A new Dept of Health report ‘Food and Nutritional Care in Hospitals, Guidelines for Preventing Under Nutrition in Hospitals’ was published last week. It outlines how this is a very serious issue which is much neglected.

Slow progress on child and adolescent mental health services

Two weeks ago, the HSE published its first Corporate Performance Report. One of its headlines was the progress made in the area of child mental health and the fact that there were now 54 child and adolescent mental health teams up and running. Are there 54 child and adolescent mental health teams up and running around the country? And what sort of services are they providing?

There are about 54 teams up and running however many of these teams are not actually teams. Under A Vision for Change, there should be 119 child and adolescent mental health teams with 13 staff on each teams.

Good news: Emergency Dept wait times are now actual wait times

It has just been pointed out to me that my comment on the HSE performance in relation to wait times is wrong. This is good news. Up to May/June of this year wait times reported in Emergency Departments (EDs) were reported from when a decision to admit was made not when a person presented at the Emergency Department (ie you could be waiting hours or days before a decision to admit was made but this was not included in official wait times). Now hospitals and the HSE are counting the time from when a person registers (ie when they first enter the ED).

In a post last weeek I said

Most hospitals are not meeting the 6 hour wait times for Emergency Departments – just 42% met 6 hour target but we know that this is not the actual wait time as the clock only starts once a decision to admit has been made, not when somebody arrives in an Emergency Department.

This was wrong the wait times reported in the new Corporate Report are actual wait times from when a person first resented at the ED. This is progress as it means the HSE and hospitals are measuring the real time that people wait, they are reporting on them regularly and we will be able to monitor progress over time.

How is the HSE performing?

This week the HSE published its first Corporate Performance Report. It’s the first of its kind from the HSE. It brings together 30 measurements and look at how the health service is performing during firs six months of 2009. It is building on the work of its monthly Performance Reports. These will allow us over time to see how the HSE is performing, albeit by its own chosen measurements…  

24 hour strike action on 24 November

Despite a day of protracted talks on 28 October, health sector unions emerged ready for 24 hour strike action on 24th November. Very little of the detail has been worked out in terms of duration or services affected but it is safe to predict that if it goes ahead it will

HSE criticised over Public Dental Service

THE HEALTH Service Executive (HSE) has been severely criticised for its failure to manage its own public dental service that provides free dental care for children, people with disabilities and older people in care. The criticisms are contained in a new report on the service. The Public Dental Service (PDS) has a budget of €60 million for 2009 and services are provided by 200 dentists, working as HSE employees.

The Department of Health appointed Dr Paul Batchelor, a London-based oral care consultant to write an Analysis and Evaluation of the Public Dental Service of the Health Service Executive , a copy of which has been seen by The Irish Times .

The evaluation report found “little evidence among senior levels of the HSE of a serious engagement to understand the operation of the PDS with a view to actively managing that part of the organisation, providing encouragement and knowledgeable direction. This lack of leadership at a national level is having a demoralising effect on the providers of the service.” It also found that “the most important factor inhibiting the introduction of improvement is the lack of clinical [dental] leadership in the PDS”.

Dentists reject ‘fraudulent claims’

The ‘dental fraud’ saga continues….

THE HSE and the Irish Dental Association (IDA) have strongly rejected reports that in excess of 10 per cent of the €85 million budget spent on a dental scheme may be paid to dentists making fraudulent and inappropriate claims. The scheme is known as the Dental Treatment Services Scheme (DTSS).

Fintan Hourihan, the chief executive of the IDA, which represents dentists, said the assertion was “misleading and unfair” while Paddy Burke, of the HSE’s Primary Care Reimbursement Scheme which makes these payments, said he was “satisfied that there is a sophisticated set of controls in place to prevent fraudulent payments”.

The €8 million-plus estimate was contained in unpublished documents on probity commissioned by the Department of Health and internal department documentation as recently as last June. Their contents were reported in last week’s Healthplus. The Department of Health has since posted the report, entitled the 2009 Report on Probity Assurance within the Dental Care Sector on its website.

Interest in inappropriate and fraudulent payments across the public health schemes

Below and above are a series of articles by me that appeared in the Irish Times health supplement on 20 and 27 October 2009 on fraudulent and inappropriate claims by dentists participating in the free public dental scheme for adults who are medical card holders.

The unpublished Department of Health and HSE documents warn that in excess of 10% of the €85 million allocated to this scheme is inappropriate. They also indicate that this abuse may not be confined to just one scheme and is happening across other demand led schemes where the HSE contracts services from professionals.

If you have information on any such inappropriate practice or payments I am very interested in hearing from you. Please get in touch….

Studies find dental fraud may cost State €8m

This article by me appeared in the health supplement in the IRish TImes on 20 October 2009

FRAUDULENT AND inappropriate claims by dentists participating in the publicly-funded Dental Treatment Services Scheme (DTSS) could cost at least €8 million this year.

Senior officials in the Department of Health and the HSE are aware of the potential savings from these claims but have not put the required checks in place to stop privately practising dentists wrongly or over-claiming from this scheme.

A series of unpublished reports commissioned by the Department of Health and the HSE, which detail the extent of inappropriate and fraudulent payments in the system, has been seen by The Irish Times.

The free dental scheme for adults available to medical card holders came to the attention of senior health officials due to the significant extra demand on it during the first eight months of this year.