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… According to the introduction from Brendan Drumm, the HSE is doing well on 70% of the 30 measures and on one third of them, they are not doing so well. Lets start with good news
THe report shows
- Good improvement on childhood vaccination – 94%, nearly at WHO rate of 95%
- Decline in MRSA, not at target but going in right direction – although I did not understand figures given…
- Child and Adolescent mental health team are on target with 54 in place by the end of June
- Breast cancer referrals – According to this report 100% of urgent cases seen within 2 weeks and 12 weeks for rest of referrals, yet June 2009 HSE Performance Report says 81.8% were seen within 2 weeks and 79% within 12 weeks – so some contradictory evidence there.
And the not so good news…
- Ireland is a real laggard in breast feeding – OECD average is 50% at 3 months, Ireland is a 34.% – much more work needed on this
- Primary Care teams – the target is for 210 teams by end of 2009, June 09, according to report, in June 2009 there were 112 PCTs holding clinical teams meetings but are they fully staffed? Are they actually happening?
- Caesarean sections – WHO recommends a rate of 5-15% – In Ireland 26% amongst highest rate in Europe.
And in some areas things have got worse?
- Ambulance response time slower in June 08 to 09
- Particularly poor in availability and length of wait for disability assessment
- 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.
And there were interesting findings in relation to public private mix. In the measurement of public private mix we have actually got worse. Between Jan and June 09, the percentage of private patients treated in public hospitals actually went up. The % of public patients as % of all patients went from 76.9% t0 75.7% between January and June. This is very interesting as it coincides with the implementation of the new consultants contract which is meant to ensure 80/20 public/private mix. This figures show that clearly this is not happening. Also, this is happening the day that Minister Harney reveals that 21,000 few people are covered by private health insurance, surely a trend in the wrong direction, if we are interested in equity…
There are lots more interesting findings in this document to check out…
I am particularly interested in how these 30 measures were chosen and why some are not in there eg how many people waiting for outpatients?, how many waiting for treatment?, how many applied for home care package and did not get it? And many more….
Overall this report is a positive move in the right direction of transparency and accountability which will allow us to track performance over time.