Consultants under fire over private work

SOME publicly paid hospital consultants are doing twice as much lucrative private work as their contract allows, a Dáil committee has found.

But health chiefs won’t tell the Public Accounts Committee (PAC) how much private work individual consultants do or even how many hours they devote to their public duties because of secrecy clauses.

PAC chairman, Fine Gael TD Bernard Allen, said it was clear from the committee’s inquiries that the rules limiting private work to 20% of a consultant’s total caseload was not being adhered to and in some specialities the private element was as much as 40%.

“The 20% ceiling on private practice was breached extensively across the board,” he said.

However, he said it was impossible to get specific details from officials in the HSE and Department of Health.

“When we looked for information on the private-public mix we were told that could not be made available to us because of contractual arrangements. We find that hard to take. It is quite horrifying in an area where taxpayers’ money is involved.”

Mr Allen was speaking on the publication of a PAC report on health service spending which severely criticises the health authorities for failing to ensure that public funds are spent efficiently.

Roisín Shortall of Labour said the PAC members were taken aback by the attitude of the health officials interviewed about the issue. “There wasn’t even agreement on the number of hours they [consultants] were supposed to work,” she said.

“Most worrying, nobody sees themselves as having responsibility for overseeing that. We put that question to [HSE chief executive] Professor Drumm and asked him why no-one was monitoring it and he could not answer. We asked the secretary general of the Department of Health and he shrugged his shoulders.”

Mr Allen said with a new contract now being implemented after years of protracted negotiations with consultants, there was an opportunity for close monitoring. “We are determined that the same mistakes are not made,” he said.

The administration of the National Treatment Purchase Fund (NTPF) was also heavily criticised. Once again, information was not supplied on the fees consultants charged to treat patients who should receive treatment in the public health services, but become eligible for free private treatment because of the length of time they spend on waiting lists.

The PAC also said it was unacceptable that more than 3,800 were treated privately by the same consultant on whose public list they had been waiting. “I am not happy at all that the NTPF is giving taxpayers value for money,” said Mr Allen.

“I am not happy, if our acute hospitals are overstretched, that there could be such flexibility within the system to allow work be done in a private capacity by consultants. It is a double payment for the same job. We believe that there is a need for a more detailed investigation of the NTPF.”

The report has been passed on to the Minister for Finance with recommendations that he direct the health authorities to radically improve safeguards to ensure public funds are properly spent.