I thank the Chairman for this opportunity to give an account of my stewardship of Beaumont Hospital as its chief executive and to address some of the issues in which I know the committee has a particular interest, including the references to Beaumont's IT department in chapter 7 of special report No. 10 of the Comptroller and Auditor General.
It important in terms of public confidence and staff morale that the excellent work done at this hospital be acknowledged. We are one of the largest acute teaching hospitals in the country, with more than 3,000 staff. In 2007, we admitted 38,000 day cases and 22,000 in-patients and we used 236,000 bed days. On top of this, we had approximately 27,000 new outpatient appointments and 109,000 return visits. We saw more than 46,000 people in our emergency department and provided 31,000 dialysis treatments.
It is noteworthy that there have been considerable improvements in a wide range of areas. As far as I am concerned, our task is to recognise where deficiencies or shortcomings exist and to put in place systems and processes to resolve them.
As a management team we are conscious of our obligation to ensure that scarce, expensive resources are used effectively and efficiently in the interests of patients. My aim, as chief executive, is to ensure that this is achieved, which is why two years ago I embarked with my team on a major hospital-wide transformation programme. We are half way through this programme now, which is breaking down traditional barriers between staff, eliminating bureaucracy and ensuring much greater accountability. Crucially, it is designed to ensure that decisions are taken where they should be — as close as possible to the point of service delivery to patients.
This is a radical programme of change and it is already making a difference for patients. For example, in our outpatients department, which is one of the busiest areas of the hospital, we have extended the working day. We now provide three sessions a day where we used to provide two, providing approximately a third more appointments using the same physical space, which is helping to reduce waiting times. These clinics have also been reorganised to improve co-ordination of services which may be required, such as x-rays or blood tests. We have also introduced an appointment system to support the work. The net effect of this approach is a reduction in the average waiting times for most appointments, significantly fewer delays for patients when they attend their clinics and better value for money for the taxpayer. In the first eight months of this year we have seen an additional 2,000 new patients, which is approximately a 20% increase over the previous year.
In our emergency department, we have successfully undertaken a range of initiatives and process improvements to shorten waiting times and have opened a 12-bed unit to provide greater comfort for patients awaiting admission to the wards. We recognise that there are still often problems of overcrowding and I am not trying to underplay these problems. It should also be recognised, however, that we are certainly doing what we can to address this issue. We have shortened waiting times for patients quite considerably. It is rare now for a patient to wait longer than 24 hours for admission and we are working hard to reduce this to a maximum wait of 12 hours within the next year and ultimately down to six hours.
Hygiene standards are also an area of the highest priority for the hospital. Following the first national hygiene audit we accepted that we had a great deal of work to do and we have done it. In the second audit, we were one of the top five hospitals audited in the country and were just two percentage points away from the highest award. Since then we have constantly improved hygiene, based on our regular internal audit assessments. The challenge for us is to ensure continual improvement.
Hygiene is an important aspect of the multifaceted problem of hospital infections. Other aspects include the appropriate use of antibiotics, moving people out of the hospital as soon as the acute phase of their treatment is completed, and the facility to isolate patients. We are actively addressing all these areas to the very best of our ability. It represents a challenge for us, but it is one that will be helped by the provision of a further 28 single rooms, which will come on stream next year.
One of the significant causes of delays in the hospital is waiting times for diagnostic services. A second MRI scanner has been installed and is coming on stream. A new CT scanner is being installed in St. Joseph's Hospital, a unit which has helped to increase our overall capacity. We took over the management of that about four years ago.
Beaumont has significant specialist expertise in several areas. These include neurosurgery, renal transplantation and cochlear implantation — all national services provided by Beaumont. Our new symptomatic breast cancer service is developing rapidly, with the transfer of services from Connolly Hospital and Drogheda helping to ensure much faster access to this vital service. In fact, our expertise in the field of oncology has been acknowledged in our recent selection as one of the eight centres of excellence now being developed under the national cancer control programme.
I would also like the committee to be aware that we have a strong value-for-money programme under way in Beaumont, which harnesses the in-depth knowledge that staff have about where it is possible to achieve cost savings without adverse impact on patient services. This covers everything from staffing levels, overtime and consumables to increased use of generic drugs, where appropriate clinically.
In short, we have recognised in Beaumont that we have two options: we can be part of the problem in respect of Ireland's health care needs, or we can be part of the solution. We have chosen the latter. We have shown leadership and determination and when problems arise we address them. More and more, we are working as a unified team that puts patient needs at the centre of everything we do. That is one of the reasons I am disappointed to be here today to discuss with this committee the specific issues concerning IT commitments. This is an issue we brought to the attention of the Comptroller and Auditor General. It involved the unauthorised creation of financial leases by a member of our staff, which committed us to payments in respect of IT contracts for hardware and software. Our management systems identified the problem and we acted swiftly and decisively. I assure the committee that all the issues raised in chapter 7 of the Comptroller and Auditor General's special report have been appropriately and comprehensively addressed by the hospital.
Before I took responsibility as CEO, I was aware that there were concerns regarding the direction of the IT strategy in the hospital. When I took my position, I took steps to ensure that the hospital would have a robust IT system that would support the activities of all departments. I quickly formed the opinion that we needed to change course on our desktop software and we successfully moved to an industry-standard solution at minimal cost in relative terms.
As the report before the committee from the Comptroller and Auditor General shows, I initiated several reviews. I initiated an internal audit review of IT spending in 2005 and tightened controls on the discretionary authorisation powers of senior executives with budgets.
Having undertaken a root-and-branch review of IT and developed a strategy for its development, I am now confident that our services will meet our needs in a cost-effective and efficient manner. The problem that arose here will not happen again and we have put additional processes in place to strengthen controls and ensure much broader transparency and checks throughout the hospital, not just in IT.
In his report, the Comptroller and Auditor General referred to the proposed development of a patient administration system. The vendor, Beaumont Hospital and the Health Service Executive are engaged in discussions with a view to ensuring that value for money is obtained by the public health service in respect of this expenditure. There is mutual intent to realise value for the public health service for this amount and I expect to be in a position to provide the Comptroller and Auditor General with further details of this agreement in the near future.
As regards the equipment and software finance leases, I confirm that negotiations between the hospital and the provider resulted in the recoupment by the hospital of €195,000 against software withdrawn, plus a goodwill payment of €100,000. This resulted in no loss to the hospital.
I will be more than happy to respond to any questions the committee may have.
