Private practice breaching limits in some hospitals

PRIVATE practice in many public hospitals continues to exceed permitted levels and, in some cases, “significantly so”, according to the Comptroller and Auditor General.

Under their contract, public hospital consultants may see 20% or 30% of private patients but breaching these levels triggers an obligation on them to pay monies into hospital research funds.

Around a third of consultants are in breach of agreed contract rates for in-patient and day cases according to the latest Health Service Executive’s summary report on consultant private practice measurement.

The C&AG’s report shows there has been very little change in the public/private mix since the new contracts were introduced in 2008.

The national total for in-patient private treatments was almost 26% in 2007 and 2008, with the ratio falling back slightly to 24.55% in 2009.

Thirteen of 49 hospitals that reported in-patient activity had rates of private practice of 30% or more last year.

The report points out that the Regional Hospital in Limerick had the highest rate of private practice at 53%, followed by another Limerick-based hospital, St John’s, where the rate was 52.4%.

Consultants have also been exceeding their contracted private practice levels for day case work.

The national private day case practice level for all consultants was 16% last year and was generally less than 30% in the 2006 to 2009 period.

The report points out that the Regional Orthopaedic Hospital in Limerick had a private practice level of almost 50% last year.