The Cork hospital at the centre of a staffing and funding row faced a risk of fines of more than €300,000 per quarter due to non-compliance with laws around working time, its regional health chief warned.
Cork University Hospital (CUH) has been under intense scrutiny in recent months after its chief executive wrote to the Health Service Executive (HSE) raising concerns about patient safety risks arising from staffing restrictions.
The hospital had hired above its allocated staff count this year, health officials have said, and had been placed under tighter recruitment controls to reduce overspending.
In a draft memo on July 20th, obtained under the Freedom of Information Act, Andy Phillips, regional executive officer, wrote to Priscilla Lynch, the integrated healthcare area manager for the Cork South and West, about staffing.
He said there were “immediate funding requirements” for contractually committed non-consultant hospital doctors (NCHD), and he raised concerns about compliance with the Organisation of Working Time Act (OWTA).
The Act sets out strict statutory limits on working hours, mandatory rest periods, and record-keeping.
Phillips said “all contractually-committed NCHD posts are to immediately be processed and entered onto payroll by the people team”.
“The necessary funding for these posts will be identified through reductions in NCHD overtime,” he said.
“Accordingly, please urgently work with CUH to develop and immediately implement a plan to absorb the cost of these additional NCHD posts through a reduction in NCHD overtime expenditure and other appropriate workforce controls.”
He outlined “particular actions” to be taken by CUH, including putting in a process for overtime, ensuring rostering complies with union agreements and strengthening “roster management and workforce planning arrangements to ensure sustainable service delivery”.
“The current rostering, overtime, non-compliance with NCHD agreement, non-compliance with OWTA and expenditure at CUH is not sustainable,” he said.
“The appointment of the additional NCHDs supports the requirement to achieve compliance with working time requirements while reducing associated overtime costs.”
He added: “Please note that the current non-compliance at CUH will garner fines imposed by HSE Centre of over 300,000 euro per quarter on CUH if unresolved.”
Asked if these fines had been imposed, a spokeswoman for HSE South and South West said the region, including CUH, “has not been subject to findings of non-compliance in relation to the Organisation of Working Time Act”.
The memo was sent a month before a heated meeting between Phillips, CUH chief executive Jennifer Kearney and senior clinical directors at the hospital on August 20th.
During the meeting, Phillips said he had been instructed by the Taoiseach’s office and the Minister for Health’s office to have some “very specific conversations” with Kearney after her patient safety concerns were leaked to the media.
Kearney had said the hospital was short 1,000 staff and raised concerns about the sustainability of the service moving into the winter period, which is typically busier.
Following reports in The Irish Times last week, Phillips recanted the statements about political interference and apologised “unreservedly”.
A spokesman for the Taoiseach said he takes “very seriously the false assertion that he said anything of this nature”.
Opposition politicians have criticised recent events. Labour Senator Laura Harmon called for “accountability for what happened at that meeting, transparency about what was communicated to Government, and meaningful action on the staffing concerns raised by CUH management”.
“Ultimately the staffing concerns at CUH have not been addressed and patient safety is at risk,” she said.
Pádraig Rice, Social Democrats’ health spokesman, said the Taoiseach “misled the Dáil” on two occasions last week about the meeting.
“This raises serious concerns for the Taoiseach. For a start, why was he so happy to contradict the official minutes of this meeting without apparently having consulted with anyone from CUH who had attended the meeting?”
Rice added that the Taoiseach must explain “when he sought clarification from the HSE about what was stated at this meeting and what exactly he was told”.