‘Perfectly feasible’ to axe private care from public hospitals

The man behind the Sláintecare report into removing private care from public hospitals has said that doing so is now “perfectly feasible, after that it’s a question for society as to whether or not we want to do it”.

Dr Donal de Buitleir, the chair of the independent review group charged with investigating the public versus private issue, told the Oireachtas health committee that “when we embarked on this it was not based on an ambition that it is unachievable”.

Dr de Buitleir acknowledged the “key reason” for removing such care from the public health system — a project expected to take 10 years at a cost of between €1bn and €5bn — is an “ideological” one and it is morally right that private patients should not be treated more quickly than public ones.

“My daughter is in primary school. Does anyone think it makes sense for me to pay her teacher to give her extra attention compared to the other kids in the class?” he said. “Insurers have told us that people buy private insurance in order to get special treatment and jump the queue. This project will also make a difference in that people will seek to access care in relation to medical need.

To the extent that private patients jump the queue, when you get rid of that, waiting times will be less. It’s fair to say that that would be an improvement.

The chief finding of the de Buitleir report, published in August, was that public consultants should have their salaries restored to the pre-recession level of €182,000 to fill the backlog of vacancies in the health service.

Dr de Buitleir said in his opening statement that ongoing reliance on private income at public hospitals (estimated at about €500m per annum) is “very risky” as such income is “declining” due to insurers telling their customers that they gain nothing by opting for private care in an emergency department (ED).

Private care is 10 times as expensive as public care. However, in an ED, there is little-to-no difference in the standard of care.

“This €524m that insurance companies pay hospitals is very, very unstable,” Dr de Buitleir said. “If we maintain the existing system it’ll drift away and we’ll end up paying it anyway because people are waking up to the fact… they’re getting nothing different.”

He said the first thing he would like to see implemented is “the legislation implemented to show the public milestones”.

“The most important thing is that new consultant appointments be made.”