Questions over Cork University Hospital spending on management consultants

30 June 2023 Consultancy.uk

Irelands midwives and nurses union has called into question spending on consultants from PwC at Cork University Hospital. The advisors were called in to lead a transformation programme, potentially accruing fees of more than €1 million, but in the months since they arrived overcrowding has reached crisis levels – leaving the Irish Nurses and Midwives Organisation calling for the contract to be axed.

As chronic illnesses, an aging population and the echoes of the pandemic continue to impact health services around the world, hospitals are having to adapt their operations to maintain a high standard of treatment for patients.

Utilising new digital and data management techniques, as well as diagnostic technology and treatment methods, healthcare is undergoing a number of transformations – and like any other sector, that has seen its bosses turn to external consultants for support.

Questions over Cork University Hospital spending on management consultants

Some healthcare professionals in Ireland are becoming increasingly dissatisfied with the value for money they are getting from advisory spending, though.

Recently, this has come to a head in Cork, with frontline staff at the city’s University Hospital calling into question an engagement with Big Four firm PwC, which they implied has led to its service suffering.

As reported by the Irish Examiner, a consultant team including 23 staff from PwC is understood to have been paid more than €1 million since October 2022, after being brought in for a "transformation and improvement programme" for Cork University Hospital, and other associated hospitals – Mallow, Bantry, St Finbarr’s Rehabilitation Unit, and CUH Wilton – known collectively as the CUH Group.

A CUH spokesperson has defended the arrangement, arguing it was “common practice” to work with management consultants through a national framework panel. They added that support from management consultants “is currently being provided to CUH to assist with a transformation and improvements programme aimed at providing better services for patients."

However, data released by CUH Chief Executive David Donegan has brought this particular “common practice” under intense scrutiny. The release shows the total cost of the programme for October-December 2022 alone came to €608,252. This saw costs rise from €61,500 in October to €266,779 in November, and in December the programme cost €279,973. If spending was maintained at that pace, it is likely to have surpassed €1 million by April 2023.

Anger is now bubbling to the surface at the PwC contract, with the Irish Nurses and Midwives Organisation (INMO) – the largest Irish professional union for nurses and midwives with 35,000 members – having warned in March, six months after PwC began its work, that overcrowding was “out of control” in Cork.

At that time, one day saw 74 patients waiting for a single bed. But by May this was reportedly even worse, as it emerged that visitors and patients had to be met in the car park of CUH to be told of delays in getting spaces due to the sheer number of patients using the hospital.

Due to the rising concern, the INMO even wrote to the Health Service Executive (HSE) – the publicly funded healthcare system in Ireland – pleading for the arrangement with PwC to be stood down. Meanwhile, Fórsa trade union has written to its members in the hospital advising them cease interacting with these consultants and not to attend or participate in meetings with them.

While the CUH CEO, Donegan, has insisted PwC staff have not been “asked to or authorised to or expected to” take on line management or operational management duties, Fórsa maintains the contrary – and issued a note to its members telling them that “trade unions have been informed that PwC are giving direction to CUH staff and attending operational meetings", before stating, “it is entirely unacceptable to Fórsa that external consultants, who are not direct employees of the HSE, are having such an active role in the running of CUH.”

The matter has now been brought up in Dáil Éireann – the lower house of Ireland’s parliament – with Labour TD Seán Sherlock arguing that the costs from October-December were “hard to square off… when people are on trolleys every day”. He added that as waiting lists were getting longer for acute and elective medical procedures, it was “very hard to understand why we have a HSE funded by the taxpayer when more and more management services and processes are tendered out to the private sector with little or no evidence of impact.”

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