I very much welcome the opportunity to raise this matter as a Topical Issue because in March this year I tabled a parliamentary question due to my concern about a potential shortfall of €5.6 million in the budget of University Hospital Kerry. In the reply I received to my parliamentary question there was an explanation of the previous model of rolled-over funding and I was informed that there has been a switch to activity-based funding. Concerns had been expressed about that. There was a key line in the response, which I will outline to the Minister of State. I was told that, in summary, the projected spend for 2017 exceeded the allocated budget by approximately €5.6 million. The reason for the variance relates largely to unexpected costs associated with agency locum consultants and non-consultant hospital doctors, additional nursing posts, and the need for additional health care assistants, all of which are necessary to provide a safe clinical service. The reply went on to say that to identify a saving of €5.6 million, the hospital needs to look at the service and identify post and non-pay items that can be removed from the projected spend. It was stated that would clearly have a significant effect on service delivery and potentially could give rise to significant clinical risk. It is extremely concerning when the HSE replies to a parliamentary question and itself flags a potential significant clinical risk to the operation of a hospital.
We know the issues hospitals such as University Hospital Kerry face in regard to recruitment. When one has an over-reliance on agency staff, in particular agency consultant staff, agency non-consultant hospital doctors and agency nurses, sometimes costing in excess of five times what it would cost for staff under a standard recruitment process, the hospital in question will run into difficulties. At the end of 2017, will we ask University Hospital Kerry to cut back on elective surgeries, equipment such as surgical devices or drug costs? Those areas of expenditure are all critical factors in the successful running of the hospital. Until we address recruitment we will struggle to a significant extent with the funding of hospital services.
On foot of the work being done by a committee of which I am a member, the Committee on the Future of Healthcare, I hope the recruitment of all staff in future will be done on a hospital group basis. We might then be able to make inroads into the staffing issue. At the moment we are asking hospitals to meet their budgets. Their only recourse to proper staffing levels is through agencies, and then we beat them up for not meeting their targets. We are putting rural and peripheral hospitals such as University Hospital Kerry in an impossible position. When I get a reply to a parliamentary question which tells me there is a significant potential clinical risk facing us towards the end of this year, it gives rise to concern. We need to provide the necessary funding until such a time as the recruitment deficit that exists is made up and allows the hospital to function properly.