Health Minister Simon Harris has branded as “brazen, immoral, and unfair” the consultants who treat private patients during their publicly contracted hours.
However he downplayed the failure of his own department to carry out an audit to ensure consultants were adhering to the 80:20 ratio of public to private practice set out in the 2008 consultants’ contract. The contract states implementation of the ratio “shall be the subject of audit including audit by the Department of Health”.
Addressing the Joint Oireachtas Health Committee Mr Harris said his department had been engaged with the HSE for “a number of months” about introducing a more rigorous monitoring system. with the aim of having it in place in 2018.
Asked by the committee why the HSE had ceased collecting data centrally in 2014 in relation to adherence to public/private ratios, the department’s secretary general, Jim Breslin, said it was his understanding that the function was delegated to group CEOs in the context of the creation of hospital groups.
Fianna Fáil health spokesperson Billy Kelleher asked if there was “a potential conflict of interest” having the HSE oversee adherence to the ratios “when private work helps fund hospitals”.
Social Democrat TD Róisín Shortall said it was “an indictment of the system that no-one knows” whether consultants are fulfilling their contractual obligations.
Ms Shortall asked why clinical directors were being paid “an additional €46,000 for supervising colleagues when clearly they are not doing their job”.
“Is it time to sack some [clinical directors] or to withdraw the allowance?” she asked.
Sinn Féin health spokesperson Louise O’Reilly asked if that was a “perverse incentive” to treat more private patients as hospitals were expected to reach certain targets when raising income from private patients.
She said the current system “not only facilities private practice in public hospitals, it encourages it”.
Mr Harris said he didn’t believe the current contract “serves the health service well” and it was his “policy position” that he wanted to see private practice removed from public hospitals, on a phased basis. He also suggested the issue of consultants not fulfilling their public obligation would be used as leverage by the State as part of its defence in a landmark court case.
Hundreds of consultants are suing the State for failure to pay agreed salary increases under the 2008 agreement.
He said the HSE was to undertake a formal investigation of each of the cases highlighted in the RTÉ programme where consultants had breached private practice limits.
Separately the HSE said it “expects all consultants to adhere to the requirements of their contract”.
“Not doing so is unacceptable and each hospital group is required to monitor and ensure the contracted public hours are being delivered by consultants.”
However when the Irish Examiner
asked for data last year on the number of consultants who had breached private practice limits and the number on whom fines were imposed, as per the 2008 contract, the South/Southwest hospital group said: “There is no amalgamated information available on individual consultant contract compliance levels.”
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