Health Minister welcomes C&AG Report on Day Surgery

Health Minister welcomes C&AG Report on Day Surgery

The Comptroller & Auditor General report on Managing Elective Day Surgery has been published before the Dáil, in accordance with the Comptroller & Auditor General (Amendment) Act 1993, which requires that the Minister lays it before the Dail.

The findings of the report are supportive of Minister Varadkar’s view that wherever appropriate Day Surgery should be used as an alternative to overnight stays for patients.

The report includes the HSE statement that day surgery should be the default option for many elective surgical procedures, unless there is a valid reason for an overnight hospital stay, such as an underlying medical condition.

“The C&AG report highlights the importance of treating patients in the appropriate setting. Making day surgery the default option for more surgical procedures should increase the number of procedures being carried out, and benefit patients by helping to reduce waiting lists. It should also produce some savings in the longer term,” Minister Varadkar said.

The Minister also thanked the C&AG for its work on the report on this most important area. Day surgery refers to treatment provided when a patient is admitted to a hospital for an elective surgical procedure and is expected to return home on the same day. It has a number of potential benefits including:

· Patients can recover in their own home;
· There is a reduced risk of hospital acquired infection;
· There is reduced cost to hospitals;
· Waiting lists are reduced, due to improved throughput of cases.

The HSE estimated that day cases were on average 60% less costly to perform than inpatient cases. A high proportion of procedure costs are fixed and day cases are generally less complex than in-patient cases. So if the level of day surgery increases, there won’t be an immediate rise in potential savings in the short term. However, the introduction of ‘Money Follows the Patient’ in the future should incentivise a move from inpatient to day surgery, and from day surgery to out-patient settings, and thus achieve savings in the costs of the relevant treatments.

The C&AG’s examination also found that it is more appropriate to set targets for individual procedures in line with current best practice, rather than setting an overall target for day surgery. Targets also need to be set at individual hospital level, given the different specialty mix of services in each hospital.

The report found that expressing performance in terms of overall day surgery rate for all procedures in each hospital is not appropriate as this masks significant differences in performance of day surgery for individual procedures.

The Money Follows the Patient approach is initially being applied to inpatient and daycase activity in public hospitals. While the new funding model will encourage hospitals to use resources at their disposal more efficiently, it does not seek to reduce budgets. Instead it provides a more transparent funding mechanism and it more fairly rewards hospitals for the activity that they undertake.