Inefficient hospitals have budgets cut by €7.5m

Casemix penalties:  Some 20 hospitals across the State have had their 2005 budgets cut by a total of more than €7

Casemix penalties:  Some 20 hospitals across the State have had their 2005 budgets cut by a total of more than €7.5 million as a result of inefficiencies.

Worst hit are James Connolly Memorial Hospital in Blanchardstown, Dublin, which has seen its budget cut by more than €1.3 million and St Columcille's Hospital in Loughlinstown, Dublin, which has lost just over €1 million.

Other hospitals significantly penalised include St James's Hospital which has had its funding cut by €827,625; Mayo General Hospital which has had its budget cut by €613,409; the Mid Western Regional Hospital in Limerick which has lost €491,316 and the Midland Regional Hospital in Tullamore which is down €449,676.

The amounts are deducted under a system called casemix which rewards efficient hospitals and penalises inefficient ones.

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Factors taken into account include their throughput of patients and the average length of stay of patients. Money taken from inefficient hospitals is redistributed among more efficient ones. The Department of Health allocates 20 per cent of hospital funding on the basis of the casemix model.

The latest casemix figures published yesterday by the Department indicate Letterkenny General Hospital is one of the most efficient in the State. It has been rewarded by having almost €1.2 million added to its budget this year. This was the single biggest reward for any hospital.

Other hospitals close to the top of the efficiency league table under casemix are the Longford/Westmeath Hospital in Mullingar, which has had €901,434 added to its budget; Galway's University College Hospital, which gets an additional €802,937; Cork University Hospital which gets an extra €765,904, Wexford General Hospital, which has received an extra €741,791 and Waterford Regional Hospital which has seen its budget increase by €554,430.

The Department said the Tánaiste and Minister for Health Ms Harney was committed to performance-related targets and casemix was the most internationally accepted yardstick.

"Hospitals are not penalised for long-stay patients. Neither are they rewarded for discharging patients too early. The system is designed to take account of each hospital's unique issues and unique patients," it added.

Spokespersons for Blanchardstown and Loughlinstown Hospitals said that while the figures affect budgets for this year, they relate to activity levels in 2003. In Blanchardstown cost containment measures implemented in 2003 adversely affected activity and therefore its casemix adjustment. In Loughlinstown changes made in 2004 were expected to change the figures around for next year, its spokesman said.

St James's Hospital said it was "dissatisfied with the outcome and the fine" and was discussing it with the Department of Health. It feels quality of services, or the complexity of patients it cares for, were not taken into account

The adjustments made to the budgets of other hospitals this year are:

St Mary's Orthopaedic (-€388,548), Monaghan (-€368,606), Cavan (-€346,384), Tralee (-€320,656), Sligo (-€313,136), Navan (-€284,153), Croom (-€195,039), Portlaoise (-€163,802), Mercy, Cork (-€157,017), Tallaght (-€119,054), Our Lady of Lourdes Drogheda (-€69,746), Rotunda (-€15,260), Temple Street (-€6,922), Holles Street (-€3,601), Crumlin (+€6,922), Coombe (+€18,862), Portiuncula (+€59,006), Beaumont (+€101,548), Mallow (+€127,113), St Vincent's (+€179,025), St Luke's Kilkenny (+€286,445), Merlin Park (+€416,490), Louth General (+€417,897), Mater (+€436,654) and the South Infirmary, Cork (+€517,443).