Irish Consultants to blame for delay in payments of €73m to Irish health service
On form: the Government says that about €73 million in payments due to the health service from health insurers is outstanding because hospital consultants have delayed in signing the appropriate forms
The failure of some consultants to fill in the forms required by private health insurers is being given as the reason why funding to the health service has been delayed
The Government has said that around €73 million in payments due to the health service from health insurers is outstanding because hospital consultants have delayed in signing the appropriate forms.
However the Government has argued that, as a result of new initiatives, the amounts due will fall significantly over the coming year.
Delays in public hospitals securing payment from insurance companies as a result of consultants not signing forms has been an issue of controversy for some time but it has been brought into sharper focus in recent weeks on foot of the cuts in front-line services introduced by the HSE.
Confidential figures produced by the HSE for the recent talks on work-practice reforms for senior doctors showed that in March there was over €11 million in outstanding claims at the Mid Western Regional Hospital in Limerick awaiting “consultant action”.
The management document, seen by The Irish Times, said this included the requirement for the consultant to sign the appropriate forms. It said over €1 million was outstanding while action was awaited from one consultant.
The report said that at Galway University Hospitals nearly €6 million was outstanding from insurance companies awaiting “consultant action”.
The figure for Cork University Hospital is €4.122 million and at Tallaght Hospital the amount outstanding is over €3.4 million.
In a topical issues debate in the Dáil last Thursday the Minister of State at the Department of Education Ciaran Cannon (speaking on behalf of the Minister for Health James Reilly) said that, as of the end of September, €204 million was due to the HSE from private health insurance companies in respect of treatment of private patients.
He said that of this €204 million, €100 million related to claims under preparation in hospitals, and €104 million related to claims submitted to insurers which were either being processed or are pending.
“Delays in consultants signing off on health insurance forms is one of the issues affecting the claims collation process in public hospitals. Of the €100 million under preparation in hospitals, €73 million relates to delays in consultant sign-off.”
Mr Cannon said that Dr Reilly had instructed the HSE “to address the issue as a matter of urgency”.
He said the HSE had directed hospitals to bring down the value of claims awaiting consultant action. He said hospitals were also targeting the highest value claims.
Mr Cannon also said that moves to deal with this issue had formed part of the proposed agreement between the Government and hospital consultants on work-practice reforms.
“An important feature of the proposals agreed between the parties was a commitment on the part of all consultants to expeditious processing and signing of claims for submission to private health insurers. Consultants will be required to complete and sign private insurance forms within 14 days of receipt of all the relevant documentation and to co-operate with the secondary consultant scheme, whereby a secondary consultant involved in a case can sign the claim form if the primary consultant has not signed it within a reasonable timeframe. “They will also be required to support the implementation of electronic claim preparation.
“Health service management is proceeding with implementation of this and other measures in the coming weeks, having regard to the relevant provisions in the public sector agreement.
“In addition to addressing delays in consultant sign-off, the HSE has also awarded a contract for the phased roll-out of an electronic claims management system in 11 HSE sites. The system will address the many deficiencies of the current paper-based process, will streamline the claims collection process and will ensure standardised work practices are implemented across hospitals. The system is live in six hospital sites with a further three to come on board by mid-November.”
Labour TD Kevin Humphreys, who raised the issue in the Dáil last week said: “Shame on the consultants that the Government had to go to such lengths to ensure the income stream and cashflow of our hospitals were guaranteed. These men and women walk the corridors of the hospitals and see the shortfall in income yet they delayed on signing off on significant sums that would make a substantial difference to the hospitals of the State.”
Mr Cannon said he agreed wholeheartedly that these were significant sums of money that could be expended on front-line services but were “held in abeyance because of a lack of will from certain ranks within the health sector and, perhaps, bureaucratic difficulties associated with the payment process”.
The delays on the part of consultants in signing insurance forms was also criticised by members of the Dáil Public Accounts Committee a fortnight ago.
At that meeting HSE national director of finance Liam Woods said that while most of the amounts outstanding were due for less than six months, the health service had been waiting for more than a year for between €5 million and €8 million.
HSE officials told the Public Accounts Committee that delays in signing the forms meant that consultants themselves did not receive payment from the insurance companies.
However the HSE declined to be drawn into speculating on the motivations on the part of senior doctors in delaying the signing of such forms.
Asked by Fine Gael TD Pascal Donohoe about what lay behind the failure to claim amounts of a significant magnitude, the HSE’s director general-designate Tony O’Brien said, “one could only speculate”.
“Either the individuals are not in need of the income or it suits them to defer that income for whatever reason.
“I am aware of a general provision in the tax code that once one is eligible to issue an invoice, one is also eligible for the tax that arises upon it, regardless of whether one has gained the income. I cannot speak to the individuals who all, no doubt, have different reasons.”
THE PAPER TRAIL: Midwestern Regional Hospital Dooradoyle has the single highest value of claims awaiting sign-off by primary consultants, with more than €11,125,000 outstanding.
The next four in order are:
* Galway University Hospital at €5,936,838
* Cork University Hospital at €4,122,930
* Waterford Regional Hospital at €3,741,323
* Adelaide Meath Hospital at Tallaght, €3,421,719.m
Ireland’s Students urged to ‘pace your drinking’
Peer pressure continues to play a major role in the drinking behaviour of young Irish adults, however a new competition aims to tackle this issue head on.
DARE2BDRINKAWARE is a multimedia competition open to all third level students in the country. It aims to promote responsible drinking and has been running for the last six years. This year’s theme is ‘pacing our drinking’.
According to Fionnuala Sheehan, chief executive of drinkaware.ie, while Irish people are, overall, drinking less than our European counterparts, ‘when we drink, we drink more’.
“This pattern of heavy, episodic drinking is particularly prevalent among young adults, including students attending third level institutions in Ireland,” she noted.
She pointed to research carried out earlier this year, which found that the average number of alcoholic drinks consumed by Irish people on their last visit to a pub or nightclub was 5.6. This is almost three times the amount people in other parts of the EU consume in one outing.
“Peer pressure remains a significant driver in the drinking patterns of young people. We want to empower them to resist the pressure to drink, or to drink more. By pacing our drinking – that is drinking less and more slowly on an occasion of drinking – we enable ourselves to get more out of our nights and our weekends,” Ms Sheehan insisted.
The competition is open to all third-level students over the age of 18. Entries can take the form of an interactive website or short film. Proposals must be submitted by November 23 and participants will then have until March 2013 to complete their entries. The prize fund totals €5,000.
“We’re looking forward to the 2013 competition and anticipate that students will demonstrate high levels of creativity in producing film and website entries on the theme of pacing our drinking,” Ms Sheehan added.
Hunting ban on red deer and curlews as numbers in the wild fall in Ireland
A ban on hunting Kerry red deer and curlews has been imposed in a bid to help protect their dwindling numbers.
A massive decline in curlew numbers — now down by up to 95pc — was behind the Government’s shooting ban.
Poaching of red deer has become a big problem because of the big demand for venison. The ban on shooting female Kerry red deer means that all reds are now protected as it had already been illegal to hunt the red stag in the county.
Heritage Minister Jimmy Deenihan removed the curlew bird from the open season for shooting wild game birds.
The curlew has traditionally had a month-long hunting season during November, although it is thought that few hunters continue to shoot the bird.
An official ban has now been introduced.
Breeding
A number of surveys and studies in the past year have estimated a dramatic reduction in the total number of breeding pairs of curlews in Ireland. These estimates indicate a decrease ranging from 60pc to 96pc.
Mr Deenihan said: “This decision will be welcomed by conservationists and hunters. I am aware that some hunting bodies have already introduced voluntary hunting bans for the curlew and I commend them for this action.”
Meanwhile, new monitoring of red deer in Killarney National Park has found a significant decline in numbers.
At the turn of the 20th Century there were in excess of 1,500 red deer in Killarney. This declined between 1900 and 1960 to as few as 60, according to the Wild Deer Association of Ireland. However, as a result of rigorous protection, numbers increased and hit around 690 in the early 1990s.
The National Parks and Wildlife Service will be monitoring compliance with the initiatives.
Message in a bottle 2 French-Canadian girls found in Quebec Canada
‘Girls wrote the notes eight years ago’
RTÉ has managed to contact the two French-Canadian girls who wrote a message and put it in a bottle in Quebec eight years ago.
The bottle travelled across the Atlantic Ocean before being washed up on the strand at Passage East in Co Waterford.
It was found by local boy Oisín Millea, aged ten.
RTÉ has spoken with Charlene Dalpé, who wrote the note along with her friend Claudia Garneau.
She said she was very excited to find out that the note, which she wrote when she was 12, had been found by somebody on the other side of the ocean.
M/s Dalpé and M/s Garneau spoke with Oisín via Skype this evening.
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