Mallow General Hospital in Co Cork has unfairly seen its budget cut by more than €570,000 by the HSE because it cannot afford to employ enough clerical staff to measure its true workload, according to a key member of its medical staff.
In a strongly worded letter published in today's Irish Times, Dr Cornelius Cronin, who works as a physician at the hospital, says the HSE's decision to cut the hospital's budget is based on inaccurate and incomplete data.
As a result, he warns that the reduction will have a "catastrophic" effect on a budget that is already under "constant enormous strain".
Noting that the hospital is one of several general hospitals to have their budgets cut for "inefficiencies" highlighted as part of the HSE's "case-mix" system of budget allocation, Dr Cronin says the hospital has the smallest budget of any general hospital in the country.
This is despite having a workload which is "far greater than many comparable hospitals".
"If Mallow General Hospital does so much with so little, how can it be that its budget is then reduced on the basis of 'case-mix', a system that supposedly rewards efficient hospitals?
"The answer is that the budget of the hospital is not sufficient to support enough clerical officers to measure patient throughput and code for patient activity.
"Therefore, the returns from Mallow every year are incomplete and grossly understate the true workload of the hospital.
"On the basis of this inaccurate data, the hospital's budget is then cut.
"The hospital is penalised for having a budget so inadequate that it cannot measure its own activity.
"Of the many problems that beset our health service, one that receives very little attention is the gross disparity in allocation of resources between different hospitals and areas. The above is an eloquent reflection of the seriousness and sophistication of the HSE in addressing this problem."
Tony Long, deputy general manager of Cork University Hospital,which also oversees Mallow General Hospital, said it was difficult to comment on Dr Cronin's claims.
This was because analysis of the "case-mix adjustment" for Mallow General Hospital has not yet been received.
"When we receive this analysis, we will be reviewing the details very carefully in order to address the issues which have given rise to the negative adjustment this year," he said.
According to the HSE, "case- mix" figures enable comparison of activity and costs between hospitals by analysing each hospital's "mix" of patients - their "case-mix" - into various groups which are clinically significant and consume similar levels of resources.
A spokeswoman said the national programme has been operating in Ireland since 1993. The 37 hospitals which participated in the programme now accounted for €3.5 billion of health expenditure annually, she added.