Vol. 515 No. 2
83 Mr. McDowell asked the Minister for Health and Children the hospitals in respect of which financial penalties were imposed due to the length of time of patient stays; the amount of the penalty imposed in each case; his views on whether it is appropriate that hospitals should be exposed to financial penalties in respect of matters that should be based on the judgment of the doctors treating patients; and if he will make a statement on the matter. [5502/00]
The casemix adjustments which were applied to the 2000 determinations of expenditure are set out in the following table. I wish to firmly reject the suggestion that the casemix system places financial considerations ahead of the welfare of patients. The casemix system uses clinical information which is based on the actual practice of medicine in Irish hospitals to determine a proportion of the funding for hospitals. The decision to admit or discharge a patient is rightly a clinical decision to be made by the individual doctor in respect of the individual patient. The manner in which hospital services in this country are organised, including the contract which hospital consultants hold, recognises this clinical autonomy explicitly.
Measures of the average length-of-stay for clinically comparable groups of patients are arrived at using information on clinical practice as it relates to over 340,000 inpatient cases in the 31 hospitals throughout the country which participate in the casemix system. The measures against which hospitals are compared in respect of length of stay are, therefore, set by the practice of doctors in the Irish hospital system and place patients and clinical practice at the centre of the resource allocation process.
All funding allocated under casemix remains within the hospital system and any funding deducted from hospitals is distributed to the other hospitals on the basis of their positive performance under casemix. Finally, I would like to say that it would be most regrettable if the casemix system, which transparently allocates funding on the basis of information derived directly from patient care, were represented as an attempt to impose arbitrary limits on clinical practice.
2000 Casemix Adjustments by Hospital
|
Hospital |
Adjustment(£000) |
|
Beaumont |
(180,874) |
|
Cavan General |
133,456 |
|
Cork University |
649,632 |
|
Regional Orthopaedic, Croom |
(155,478) |
|
Louth County, Dundalk |
136,473 |
|
James Connolly Memorial |
(214,654) |
|
Letterkenny General |
326,843 |
|
Limerick Regional |
31,600 |
|
Longford/Westmeath (Mullingar) |
7,086 |
|
Our Lady of Lourdes, Drogheda |
(196,720) |
|
Mallow General |
(23,739) |
|
Mater |
(188,226) |
|
Mayo General, Castlebar |
230,224 |
|
Mercy, Cork |
(46,030) |
|
Merlin Park, Galway |
124,043 |
|
Monaghan General |
44,367 |
|
Navan General |
(72,955) |
|
Portiuncula |
(84,575) |
|
Portlaoise General |
(64,611) |
|
Sligo General |
110,502 |
|
South Infirmary/Victoria |
41,543 |
|
St. Columcille's, Loughlinstown |
(216,559) |
|
St. Luke's, Kilkenny |
67,483 |
|
St. Mary's Orthopaedic, Cork |
(138,755) |
|
St. James's |
(305,640) |
|
St. Vincent's |
(50,379) |
|
Tralee General |
(1,500) |
|
Tullamore General |
(183,409) |
|
U.C.H Galway |
239,468 |
|
Waterford Regional |
(2,312) |
|
Wexford General |
(16,305) |
