The St Vincent’s Healthcare Group, which runs two public hospitals in Dublin, is facing a potential financial deficit of €12.8 million for last year.
The group, which operates St Vincent’s University Hospital in Elm Park in south Dublin and St Michael’s in Dún Laoghaire, recorded a deficit of €14.9 million in 2023.
It said its board believed this money “remains owing” to the group for services provided with the full support of the HSE under its service agreement.
The group in recent months has argued that financial limits were set by the HSE last year “in an arbitrary way, without consultation” and that there were “glaring inconsistencies and inaccuracies”.
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It criticised “increased bureaucracy, scrutiny and unrealistic expectations” on savings and efficiencies that could be achieved.
Group chairman Conall O’Halloran told HSE chief executive Bernard Gloster in November that it believed it should receive “a lot more support from the community to facilitate delayed discharges, nursing home, step-down or rehabilitation beds”.
“We are currently paying € 4.5million for access to 50 step-down beds in Marley Nursing Home provided under the Nursing Home Support Scheme Act,“ he said. ”These patients no longer require acute hospital care and therefore the acute hospital should not have to provide the funding for what are essentially community services.”
Mr O’Halloran said St Vincent’s was “the home of several national specialities”, including liver and pancreas transplantation, pancreatic cancer and sarcoma and cystic fibrosis, but these high-cost specialities were “not resourced as line items and they are included under our overall spending limits”.
“We have just commenced building works on a long agreed national plan to provide six additional critical care beds, which supports our own as well as the regional ICU needs. This necessitated the closure of 26 beds. When we sought regional support for additional beds it was suggested we consider postponing the work even though contracts had been signed and the break clause includes a €1 million penalty, a cost which we clearly could not pay, even if we agreed with that option”, Mr O’Halloran said.
The revelations regarding the financial situation at the St Vincent’s group come as the representative body for the voluntary hospital sector again expressed concern about the level of historic deficits on the books of its member institutions. These are believed to collectively exceed €200 million and some hospitals are worried that these could threaten their financial solvency.
The Irish Voluntary Healthcare Association maintained that “in recent years Ireland’s acute and subacute voluntary hospitals have been underfunded on an ongoing and annual basis, due to a disconnect between the service level agreements and the actual demand for healthcare”.
It said this had led to “ever accumulating deficits”.
There had recently been constructive talks with the HSE that “focused on identifying ways of providing voluntary hospitals with the autonomy to conduct their work while delivering an efficient service”, the association said, adding that this should include a move to a multiannual funding model.
However, the association said these talks were “not designed to address the issue of accumulated deficits”. It maintained that boards of individual institutions “continue to face liquidity concerns”, where the level of debts accumulated ”could call into question the ongoing solvency of a hospital”.
Voluntary hospitals receive the bulk of their funding from the State and staff are considered to be public-service personnel. However, they are independent of the HSE and have their own boards.
Such hospitals include Tallaght, the Mater, St James’s, St Vincent’s in Dublin as well as the Mercy in Cork.
In his letter to the HSE, Mr O’Halloran forecast that the St Vincent’s Healthcare Group could face a deficit of up to €20 million for last year.
A spokeswoman for the group told The Irish Times that following ongoing engagement with the HSE, its “operational funding gap for 2024 currently stands at €12.8m, subject to audit adjustments”.
