Health service insourcing viewing as a temporary, rather than long-term, solution on our website
The Health Service Executive's (HSE) loss of confidence in the third-party insourcing initiative has become a political liability for the Government, as the Minister for Health, Jennifer Carroll MacNeill, grapples with the decision to wind down the practice. This initiative, introduced by former health minister Stephen Donnelly, aimed to reduce waiting times by encouraging private companies to use spare capacity at public hospitals to provide services to patients on public waiting lists.
The third-party insourcing model, which involves external companies delivering healthcare services outside of normal working hours but using HSE facilities and equipment, has generally been accepted to have made a material difference to waiting times. However, the cost has proven problematic, with over €70 million paid to just three companies (EHF 29, Rosata Recruitment, and Totally Healthcare) for insourcing activities over 27 months. In total, the HSE has spent over €1.1 billion on both insourcing and outsourcing to tackle waiting lists since 2023.
Concerns about potential conflicts of interest and perverse incentives in third-party insourcing have been raised and appear to have materialized in some controversies. The HSE CEO, Bernard Gloster, has recommended phasing out third-party insourcing by the end of the year, citing the model's unsustainable nature and the need for long-term solutions.
The underutilization of resources at public hospitals, partly due to working hours and rostering limitations, was utilized by this initiative. The HSE has agreed to new rostering arrangements for staff and hospital consultants to use equipment and facilities more efficiently, particularly over weekends and in the evenings.
As the Minister for Health reviews the use of third-party insourcing, she is exploring other mechanisms to reduce waiting times in a more sustainable way. Alternatives could include recruiting and training more full-time HSE staff, improving internal workflow efficiencies, and modernizing healthcare infrastructure. Contracting strategies that emphasize resilience, supplier due diligence, and early problem detection could also optimize service delivery and reduce risks associated with third-party providers.
In summary, while third-party insourcing in Irish healthcare has been an effective short-term measure to reduce waiting lists, it has been very costly and poses challenges of sustainability. The HSE and government are considering phasing out or reducing reliance on such external providers and seeking longer-term, cost-effective alternatives focusing on bolstering public healthcare capacity and improving efficiency.
- The controversy over third-party insourcing in healthcare, with its associated financial implications, has become a hot topic in the realm of politics.
- The medical-conditions sector has seen a significant investment due to the large sums spent on third-party insourcing initatives since 2023, according to general news reports.
- The Health and Wellness industry, particularly within the Irish context, is facing questions about the sustainability of third-party insourcing as a solution for reducing waiting times in a cost-effective manner.
- In the business and finance arena, there's growing interest in contracting strategies that prioritize resilience, due diligence, and early problem detection to optimize service delivery and minimize risks associated with third-party providers.
