Harney and Drumm at odds over HSE losses

HEALTH Minister Mary Harney has challenged claims by health service chief Prof Brendan Drumm that he did not anticipate a loss of income as a byproduct of the new consultants’ contract.

Ms Harney said she wrote to the Health Service Executive (HSE) outlining the budgetary implications.

“I made it clear to the HSE that they could not charge [private health insurers] for patients who were being treated by doctors that had a full-time public salary [category A contract],” Ms Harney said yesterday.

On Thursday, Prof Drumm told a Dáil committee that he had not anticipated an estimated €50 million loss of income from private health insurers (PHI) as a byproduct of the new contract.

However, communications between officials in the HSE in March and April show they were aware of the financial implications.

On March 23, Fergal Goodman, principal officer with the HSE acute hospitals division, wrote to Alan Moran, chair of the HSE PHI working group, advising that a patient “may only be regarded as having ‘private’ status where he/she opts to avail of private consultant services”.

“As category A consultants do not undertake any private work, there is no basis on which a patient under the care of such a consultant could be accorded ‘private’ status... Public hospitals may not, therefore, raise a private accommodation charge where the patient is admitted under the care of a category A consultant,” Mr Goodman said.

HSE correspondence also indicates it advised the Department of Health of a substantial loss of income as a result of the rule change and it reveals the projected losses had not been recognised in any HSE budget projections for 2009.

The correspondence contradicts what Prof Drumm claimed on RTÉ radio yesterday when he said the HSE view was at odds with the Department of Health view in relation to whether they could bill the insurers for private patients admitted by public consultants.

“The department view was that we could be challenged, our advice was that it couldn’t,” Prof Drumm said.

A statement from the VHI yesterday said it was “surprised” by Prof Drumm’s comments and that the situation under the new contract had been clarified to them by the HSE.

The HSE also wrote to the VHI asking them to inform customers of the rule changes.

The VHI wrote back to the HSE requesting the names of consultants operating under the new Type A contracts. This information has not yet been supplied.

Yesterday, Ms Harney, who was attending the Irish Nurses Organisation annual delegate conference in Killarney, said she didn’t understand the confusion about the effect on HSE income of the new consultants’ contract: “The HSE will get more money this year from the VHI than what they got last year, I don’t understand the budgetary issue. I wrote to the HSE in relation to this matter so there shouldn’t be any doubt about it.”

Ms Harney said income from private health insurers was already up this year.

The VHI said it has paid €73m for the first three months of 2009 compared to €60m for the same period in 2008. Ms Harney also said the VHI would be advancing €50m for money owed for patients treated over the past 14 months.