Healthcare costs - not insurance "Tens of millions in HSE money lost, say auditors"

Any time I challenged the hospital vague billing with insurance neither party was interested. Unitemised bills were par for the course. Faced with that sort of fecklessness I gave up.

In my personal experience the amount of time wasted through poor processes and systems was vast. But it doesn't seem to be quantified anywhere.

So none of this surprises me.
 
Purple said:
Relative to that this is a side show, a distraction.
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€723k is pay for 3 consultant-level doctors for a year, or [EDIT] one WTE for 3 years. It could shorten waiting times for patients, thereby saving serious discomfort or maybe even lives.

We've agreed on the waste in the HSE before, the waste no-one seems to have the will or the guts to tackle, but this is real hard cash lost, our money.
 
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mathepac said:
€723k is pay for 3 consultant-level doctors for a year, or the equivalent for 3 years. It could shorten waiting times for patients, thereby saving serious discomfort or maybe even lives.
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Or we could get the doctors we already have to work shifts, along with the technicians who run the diagnostic machines etc, and have tens of billions of Euros of capital assets producing 24 hours a day instead of 6-8 hours a day.
I think that's a better discussion to have.

mathepac said:
We've agreed on the waste in the HSE before, the waste no-one seems to have the will or the guts to tackle, but this is real hard cash lost, our money.
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The HSE is just a name. In reality the health service is hundreds of semi-autonomous semi-connected and semi-integrated organisations only thing they really have in common is that they have the same stationary. That wastes hundreds of millions a year in duplicated processes and, worse, wastes hundreds of millions of work hours on those duplicated processes.
I also think that's a better discussion to have.
 
Purple said:
The HSE is just a name. In reality the health service is hundreds of semi-autonomous semi-connected and semi-integrated organisations only thing they really have in common is that they have the same stationary.
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A layer of management plonked on top of the old health boards, with the old health board management still in place.

They actually messed up the HSE stationary. A fancy document was produced explaining the meaning of the 'HSE' logo and different colours used etc etc. New stationary ordered, signage ordered, systems updated with the new logo etc. Then it was discovered the Irish translation was wrong...

This is the original version of the logo:

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mathepac said:
Don't worry folks, improvements are imminent, maybe as soon as the end of this month, more than four years later.
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Yep, it's a great pity that the HSE didn't simply go into the nearest Centra and buy a bespoke integrated financial management system off the shelf! Our local Centra had one for €199 a few years ago - I bought a few for the kids.

Incidentally, given that the overpayment was made in December 2021 your maths are a bit sketchy if you think that July 2025 is "more than four years later"!
 
Nit-pick all you like about my use of calendars, the matter at issue here is the HSE's profligate waste of taxpayers' money, and the loss of €50.4 millions of it in a single year, according to my sketchy maths. Mind you, that's €50.4 millions of identified losses.

Three years and almost 7 months and counting without recovering a single red cent of the €723k loss.
 
misemoi said:
Overall the control preventing duplicate payment failed but the consequences of this control failure are not as severe as say the NTMA issue which was a payment made to an unknown organisation. Even some of that has since been recovered.
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What payment was that?
 
The more interesting question is whether the inflation-busting increases in health spending over the last five years has had a commensurate increase in the quality of medical care.

This is a question that external audit is neither designed nor equipped to answer
 
PMU said:
The HSE was set up in 1975 and I would have thought in that time period someone would have advised that invoices be checked against purchase order numbers, prior to approving payment. [And if you can make duplicate payments, is there not a risk that uninvoiced payments can be made? Is that not the real risk here?]
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I worked in the Health Board in 1990 in accounts payable, there was a process to ensure that invoices weren't paid twice. It worked afaik.

We got the new system a few months. An absolute mess. The audit of 2025 will be interesting reading I'd say.

BTW Health Boards were set in 1970, HSE in 2005.
 
mathepac said:
Three years and almost 7 months and counting without recovering a single red cent of the €723k loss.
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Given that the double payment - which isn't necessarily a loss - is mentioned in the HSE's accounts for 2024, I suspect that the double paymemt was only identified last year. I would expect it to be resolved before the end of this year, because if it isn't then the C&AG will savage the HSE in next year's report!

Moving from the specific to the general, it's clear from the Irish Times Report* that the management by the HSE of that particular supplier's account been utterly abysmal - I hope that the supplier remains solvent so the HSE will be able to rectify its blunders.

* The supplier who was paid twice had entered into an arrangement with the HSE in 2020 for the supply of diagnostic devices, ancillary supplies and equipment as well as information technology and support. It says the overall system “was considered to be of significant value in monitoring the condition of Covid-19 patients in hospital settings”. However, the report raises concerns about procurement arrangements and controls over how the money was being spent:
  • initial arrangement with the supplier was put in place (in 2020) without a competitive procurement process on the basis of emergency circumstances
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  • arrangement continued each year until 2024 without being regularised through an appropriate competitive tendering process
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  • the terms of the procurement arrangement were not set out in a formal written contract with the supplier
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  • In practice, the arrangement was that a number of units of the Health Service Executive were invoiced from time to time by the supplier for devices and ancillary items. This included prepayment (!!!) each quarter from mid-2022 to mid-2024 for supply of a standard number of devices, to be drawn down as required by individual hospitals
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  • the HSE did not maintain central records of the total number of units paid for.
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  • The number of devices received by hospitals, or paid for and remaining undrawn from the supplier is not known.
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  • The Executive does not know how many of the items paid for were actually used in its hospitals
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Now that is a scandal!
 
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