asked the Minister for Health whether the information systems presently being installed in hospitals will generate speciality costs by consultants which would be of use in clinical budgeting; and the hospitals in which this information system will be available.
Ceisteanna — Questions. Oral Answers. - Hospital Clinical Budgeting.
7.
The patient administration and financial systems will, when fully developed, integrated and tested, enable speciality costing to be carried out. This will, in turn, facilitate clinical budgeting. The system will be installed in all major acute hospitals on a planned, phased basis.
Is there any danger that computerisation would be confined to non-medical items like transport and stock control in the early phase and that getting into the medical end could be shelved?
I hope not. It is essential that we have the administration system working as quickly as possible and the Macauto system is at present being implemented in Crumlin, Tralee General Hospital, Cork Regional Hospital and arrangements for implementation are at an advanced stage in the case of the Hospital and Cork Regional Hospital and Hospital, Drogheda. Assuming successful implementation of these sites it is proposed to install the system in nine or ten other major hospitals. I can assure the Deputy that I will be extremely anxious to apply it to the speciality costing area as well as the clinical budgeting side because with the existing system, it would be possible to have a fully developed speciality costing system. It may take the best part of five years to do that but it has to be done urgently.
Do I detect the possibility that the present facility may have some deficiencies in this area when the Minister says it is still at the pilot stage?
There has been a lot of difficulty with the system but the first basic requirement is the hospital financial and administration systems. After that we go to the clinical budgeting. I am very anxious to develop in all hospitals comprehensive clinical budgeting systems. The sooner we have them the sooner we will be able to say precisely how much it costs to run a hospital. There is a great deal of information which is not available to anybody, including those who run the hospitals.
Is it the Minister's intention that there would be a uniform system in all hospitals? Is there a reappraisal of the Macauto system going on at present? Do his Department intend to fund the installation of these systems in both State and voluntary hospitals?
We have been funding hospitals right across the board, for example, the Mater Hospital and Our Lady of Lourdes Hospital, Drogheda which are voluntary hospitals. Admittedly the Macauto system is a complex system but it has not reached the stage at which it requires any policy review on our part. I am disappointed at the pace of installation. The costs, which will run to many millions of pounds, will be met by the Department. We are spending £10 million a week but I would willingly spend £10 million to find out how the other £540 million is being spent. Frankly we do not know.
Will there be a uniform system?
Yes, as far as possible.
Could the Minister give a time scale as to when we might see the first results from a hospital on the clinical budgeting side?
This year I will be bringing forward further proposals. I find that I am getting the support of the general medical staff and the consulting staff in the hospitals. They are generally supportive of the idea, despite any other differences I might have with them.