Mater Hospital CEO Highlights HSE Funding Shortcomings to PAC

Josephine Ryan Leacy, CEO of the Mater Hospital, informed the Public Accounts Committee (PAC) that the HSE's current single-year funding model for voluntary hospitals is not keeping pace with demand or patient needs. She advocated for reform, proposing a multi-annual, activity-based funding system linked to volume, patient complexity, age profile, and national referral responsibilities to ensure transparency, better planning, and accountability.

Ryan Leacy stated that without a 2023 «risk-sharing» deal with the HSE, the Mater Hospital would have had to reduce or suspend essential patient services. She noted that negotiations often start from the previous year's baseline, despite clear year-on-year growth in demand, undermining financial planning and recruitment as agreements are frequently finalized late in the financial year. She also confirmed that all National Treatment Purchase Fund (NTPF) related activity is fully compliant, with no identified staff conflicts of interest.

In 2024, Mater, St Vincent's, and Tallaght university hospitals collectively received over €1.5 billion from the HSE under Section 38 arrangements. Barbara Keogh Dunne, CEO of Tallaght University Hospital, reported an 8% increase in emergency department attendances last year, with an 11% rise in patients over 75. This trend continued into Q1 2024 with a 12% increase in attendances and a 6% rise in admissions, despite patient flow improvements. The hospital operates at 110-115% occupancy, causing delayed admissions, and saw almost 205,000 outpatient attendances in 2023, a 5.5% increase.