Health insourcing and outsourcing
Deputy Rice criticised over-reliance on insourcing and outsourcing in the health service and called for better oversight. The Minister said the national assessment was necessary and that Sláintecare reforms and investment in infrastructure remained priorities.
My question relates to the insourcing and outsourcing of public healthcare. Yesterday, the Minister for Health published the HSE review of insourcing and outsourcing, which I welcome. The report confirms that the health service is over-reliant on these arrangements to reduce waiting lists. Despite the huge sums of public money involved, proper oversight has been severely lacking, leading to alarming and shocking abuses of the National Treatment Purchase Fund, NTPF, and clear conflicts of interest. While it is welcome that insourcing arrangements are to be phased out by June 2026, we also need to end the over-reliance of the health service on outsourcing to private hospitals and other external companies.
This aim is referenced in the review, but there is no timeline or action set out. Obviously, this cannot be done overnight. If it is to be achieved, we need to accelerate the delivery of Sláintecare reforms. By 2028, four new elective hospitals were due to be delivered, but no planning applications have been submitted nor have business cases been approved. In May 2023, the then Minister for Health announced the delivery of six new surgical hubs within 18 months, but only one new hub has been opened 25 months on. Can the Minister commit to accelerating the elective care reforms and, crucially, funding them so that the dependency on outsourcing can be reversed?
Comment on this
It was very important to conduct the national assessment of insourcing, which I commissioned at the beginning of April because of my concerns, and to publish it. The Deputy has had an opportunity to consider it today. We have to use every lever to implement Sláintecare, including rostering for five over seven days, the public only consultant contract and making the best case possible for as much investment in health infrastructure as this Government can do collectively. That includes elective hospitals and surgical hubs. I understand the surgical hub in Mount Carmel has seen over 1,000 patients; that is my understanding from the CEO of St. James's. I have asked for detailed information on what exactly has been happening and when.