Hospital consultants must do their sums
Mr Hurley backed proposals made last week by the Brennan Report that consultants should be made responsible for their own budgets.
“What I would like is that each consultant would have their own budget. It would be for them to decide what treatment regime what drugs, what diagnostic tests to undertake.
"But whatever they do will be charged against their own balance sheet,” he said.
Mr Hurley said consultants were critical to the success of the Government’s health reform package.
But without their co-operation the radical changes proposed by the Brennan and Prospectus reports, and the yet-to-be published Hanley report, could not work, he said.
The Hanley report, expected to be officially launched next month, will see the controversial redistribution and slimming down of acute hospital services.
“There is no doubt that our acute hospitals under the National Hospital’s Office will have to be reconfigured and critical to all of that is going to be how our consultants are going to deliver a consultant provider service,” Mr Hurley said.
The comments come as consultants, angered by proposals to restrict and make more accountable their work practices, gear up for a major confrontation with Health Minister Micheal Martin.
Although neither side has fully laid their cards on the table yet, any attempt to strip lucrative private practice work from the powerful consultant lobby will be strongly resisted.
But Mr Hurley said value for money in any restructured health service was dependent on the consultants taking on board the full financial implications of their decisions.
“Consultants are absolutely critical particularly in our acute hospitals. The majority of the costs in our acute hospitals are determined by our consultants,” he said.
Consultants are also firmly locked in long term discussions with the Department of Health over the state indemnity scheme for health professionals.
Hospital consultants are the only public sector group who have refused to co-operate with the new Government agency dealing with compensation claims arising from accidents or malpractice.
Speaking on RTE radio yesterday, Mr Hurley also welcomed the thrust of the Government’s new health reform programme, launched on Wednesday, saying that radical reform was long overdue.
“We’re going to have a far less cluttered structure from here on in with very clear lines of accountability and we will know who is in charge and who is responsible,” he said.
The elimination of politicians and their local interests from health boards was also a very necessary step he said.
“We have had situations in the past where decisions have been taken by boards which are contrary to the evidence presented to them.
“It’s almost impossible to have rational planning if decisions are taken on the needs of local people. Decisions must be taken on the needs of all the population,” he said.
