Major gaps in private hospital system

There are “very significant gaps” in the private hospital provision of cancer, cardiac, and orthopaedic services across the southern region.

People with private health insurance who live in the Cork catchment area are getting less value for money than those who live in Dublin and Galway.

And Cork is the only city in Ireland which has a designated cancer centre but does not have a private radiotherapy service. This is despite its catchment area accounting for 22% of all cancers diagnosed nationally.

These are among the key findings of a new confidential report, which has been seen by the Irish Examiner, assessing the unmet privately insured demand for private hospital services in the Cork region. The report was commissioned by the Mater Private, which plans to develop a 75-bed private hospital in Mahon, on the outskirts of Cork City.

It shows the region will need more than 400 new private hospital inpatient beds to cope with predicted demand by 2026.

The document, prepared by PriceWaterhouseCoopers, defined the Cork catchment for private healthcare services as Cork City and county, Kerry, Waterford, Limerick, and Tipperary.

It estimates there were 462,000 people with private health insurance in the area — the equivalent of 20% of the national market — in the region, with 290,000 of those living in Cork City and county.

The report shows that everybody in the catchment area with private health insurance needed 827 full capacity private inpatient beds in 2010.

By 2026, based on demographic movements alone, this bed need will grow to 1,164, the report shows.

The report said private health insurance members in the area have not benefited from the major programme of investment in private healthcare that has occurred over the last decade.

Dublin, Galway, Waterford, and Limerick have seen investment in private bed capacity, theatres, linear accelerators, and cath labs.

“The implication of this has been a gradual deterioration in the accessibility of private healthcare services in the Cork catchment relative to other areas,” it states.

About 85% of the estimated 515 in-patient beds in private hospitals in the catchment area are owned and operated by the Bon Secours Health System.

Total private bed stock, which includes public and private, is estimated at 1,010. But this equates to an effective supply of 717 inpatient beds when maximum private in-patient occupancy in both systems is factored in.

“The extent to which the public system will be able to continue to provide services at the existing level to private patients is now under question,” the report said.

It estimated that half of all Vhi Healthcare members in the area had to rely on public hospitals in 2010. “It is estimated that a quarter of these members’ bed-days are accommodated in a public bed, at the expense of the Irish State,” the report said.

“The 4,451 private healthcare members accommodated in public beds derive no hospital benefit from the healthcare membership.”

The research also said Cork private health insurance members do not enjoy the same access to private hospitals as their Dublin or Galway counterparts.