A ZERO-TOLERANCE approach must be adopted towards absenteeism in the health service, according to the new chairman of the HSE board Dr Frank Dolphin.
If absenteeism rates were halved at least €100 million could be saved annually, he said yesterday. Addressing the annual conference of the Irish Association of Directors of Nursing and Midwifery, he said absenteeism among HSE staff was running at 4.5 per cent overall but ranged from 1.3 per cent to 5.3 per cent.
“We need to introduce zero tolerance and a zero-tolerance culture towards absenteeism. There are major costs associated with this and any of us can do the maths on it . . . we need you as managers and leaders to redouble your focus in this area. I have a view that in the past we have made it far too easy for the non-genuine cases and you know the impact that has on the wards, on your colleagues and on the bottom line,” he said.
“Our challenge is to strike a balance between ensuring genuine cases are dealt with humanely while at the same time driving inefficiency out of the system.”
He said with the impact of the moratorium on recruitment and the reduction in use of agency staff the impact of absenteeism went back on to colleagues. He said that while before the HSE “took a softer approach” that now “must change” because all areas have to be focused on in terms of cost management.
“If we achieved a 50 per cent saving and brought that [absenteeism rates] down from 4.5 to 2.25 per cent we would have a significant cost saving. . . it wouldn’t be difficult to achieve savings of upwards of €100 million,” he said.
Dr Dolphin admitted it would be challenging for the HSE to try to achieve further savings of at least €600 million next year. “That will require us to delve deeply into all areas where we can control cost and where we have access to controlling cost. It will ultimately require radical thinking in terms of the approaches to our service and in terms of peoples’ expectations of the service because if we are to on the one hand provide high-quality service and leading-edge medical technology that requires efficiencies . . . that will require national reconfiguration.”
“The primary focus has to be to protect the front line. They have taken a hit already,” he said.
Earlier Dr Dolphin told delegates that in healthcare, just as in other areas of life, expectations had rocketed, partly driven by the internet. Patients were now very informed and educated and as a result people often focused on what the health service couldn’t do rather than what it could do for them. It was time to focus on how it was that the good things being done were glossed over. He said the HSE needed to be cleverer at how it did this. He would like every patient leaving hospital to be given an invoice outlining what was done for them, the cost and stamped “paid for by the HSE”.
Meanwhile, Dr Eugene Donoghue, chief executive of An Bord Altranais, said the number of fitness to practise inquiries into complaints made against nurses had increased from three in 1998 to 34 in 2008. But given there were over 69,000 nurses registered, a very small percentage ever came before fitness to practise.