NONE OF the additional consultant posts announced by the Health Service Executive (HSE) a year ago as a reward for hospitals that had made improvements in their accident and emergency services has been delivered, due to financial constraints.
In August 2007, the HSE announced that 60 additional consultant posts would be provided under a controversial incentive scheme to 24 hospitals that had fared well in meeting targets for reduced waiting times for patients in AE departments.
A further 40 additional posts were due to be announced by the HSE later in the year as part of the incentive scheme for hospitals, which was known as 100-plus.
At the time of the announcement, the HSE signalled that the 60 posts would not be advertised for a time, to allow talks between health service management and medical organisations on a new contract for hospital consultants to continue. However, HSE chief executive Prof Brendan Drumm has confirmed that these promised additional posts announced under the incentive scheme do not form part of the 180 new consultant posts advertised by the HSE following agreement on a new contract earlier this year.
Prof Drumm told The Irish Times that the HSE wanted to establish these additional posts under the incentive scheme as a package. He said that he regretted the delay in making these appointments, as he had given a personal commitment on the isue. He added that improvements in emergency services had been delivered. He said that if money was freed up at the end of the year he would consider the establishment of the posts as a priority.
Almost immediately after the announcement of the additional posts, the HSE ran into financial difficulties which, effectively have continued ever since. The organisation is facing a potential €300 million shortfall this year. Under the announcement made last year, the 60 additional posts to be provided were to be in a range of specialties including emergency medicine, radiology, general medicine, general surgery and geriatric medicine.
The hospital which stood to benefit most from the scheme was the Mid Western Regional Hospital in Limerick, which was to receive eight additional consultant posts. Other hospitals rewarded under the scheme included St James's and St Vincent's in Dublin. These were each due to get six new consultants under the scheme.
Critics of the HSE plan, however, argued that hospitals excluded from the scheme were being unfairly penalised for problems which were outside their control. It was argued that many of the hospitals rewarded by the HSE traditionally had few people waiting in AE.
Some hospitals which had been struggling to cope with overcrowding in AE, such as Beaumont and the Mater in Dublin, did not receive any additional posts under the incentive scheme.
Critics argued that a number of unrewarded hospitals were among those named in the HSE's own AE taskforce report, published in June last year, as unfit for their role.