The proportion of medical tests known as scopes conducted at weekends has increased significantly over the past 15 years, but there is a notable variation between hospitals, figures suggest.
These procedures are carried out using endoscopes, which are long, thin, flexible tubes with a camera and light source at the end to see the inside of the body.
The figures revealed that 2 per cent of scopes were carried out on Saturday or Sunday in 2010. By last year, this figure had increased to 13 per cent.
But the figures, which were released in response to a parliamentary question from Sinn Féin health spokesman David Cullinane, highlighted a significant variation between hospitals.
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Cavan General Hospital had the highest proportion of weekend scopes, with 49 per cent of such procedures being completed at weekends.
Drogheda Hospital had the second highest at 46 per cent, followed by Cork University Hospital at 36 per cent.
Mallow and Nenagh hospitals did none, while Waterford and Dublin’s Connolly hospitals conducted 1 per cent of scopes at the weekend.
The health service has been seeking to move away from a Monday-to-Friday daytime working week and to increase the number of procedures conducted at the weekend and evenings.
An HSE spokeswoman said there were “many reasons” weekend activity varied from site to site such as “availability of capital infrastructure and staff, seasonal factors or some of these could be targeted initiatives that the sites carry out to reduce the waiting lists”.
A spokeswoman for the Department of Health said the Government was “committed” to providing a seven-day health service for the public, which will “make better use of our infrastructure if we extend the working day and working week and spread out the staff to fully maximise our physical assets”.
She said there was variance across hospitals in relation to productivity and to specialisms within sites. Minister for Health Jennifer Carroll MacNeill will be making this information publicly available shortly, the spokeswoman said.
There has been a focus on weekend working in the health service in recent weeks after a 2022 internal report from CHI, which has not been published but has been leaked extensively, noted a consultant in a Dublin children’s hospital was referring patients to Saturday clinics that were funded by the National Treatment Purchase Fund (NTPF) to reduce long waiting lists.
The consultant was seeing twice as many patients at the Saturday clinic, for which he received additional money, than during his weekday equivalent, the report said.
This has created concerns about “insourcing” through the NTPF – where hospitals and their staff receive additional payments for providing treatment to patients waiting longest for care outside of core working hours or at weekends.
Mr Cullinane said there were three “critical areas” that required answers following the release of these figures: whether conflicts of interest were being managed; if there was a “perverse incentive” for insourcing; and if productivity during Monday to Friday was sufficient.
“For some hospitals, doing the work at weekends makes sense. Some people find it easier to get through planned procedures at the weekend,” he said.
“But this would raise concerns around productivity Monday to Friday. The whole point of the new consultant contract is to get more productivity across the six days. The variation between hospitals needs to be explained.
“The NTPF should be about balancing waiting lists, if it’s being used as another income stream then we would have concerns about that. That’s something we need answers on.”
Representatives from the HSE, NTPF and CHI are all due to appear before Oireachtas committees next month to discuss waiting lists and the use of funding to tackle them.
