Donohoe assured by Harris that De Buitléir report findings would be non-binding

The Minister for Public Expenditure and Reform Paschal Donohoe requested, and received, repeated assurances from Health Minister Simon Harris that the recommendations of a key report into removing private care from Irish hospitals would be non-binding.

On at least three occasions prior to the publication of the De Buitléir report into the creation of a single-tier healthcare system, Minister Donohoe asked for confirmation that the findings of the report would not necessarily have to be implemented.

The final document was published in August 2019, after a delay of six months, having been presented to Government in February of last year.

Mr Harris’ August letter was in reply to a message from Mr Donohoe from the previous week, in which the latter was sharply critical of the budget requests that had emanated from the Department of Health for 2020.

In the midst of that three-page letter, which primarily dealt with the cost pressures being placed upon the health service, Mr Harris said in regard to De Buitléir: “My Department has on at least two occasions confirmed to your Department that it will be made clear, on publication of the report, that the Government is not bound by its recommendations, and that the over-riding primacy of pay policy will be emphasised. I am happy to do so again,” Mr Harris said.

He added however that he was “committed” to the removal of private practice from public hospitals, a “fundamental plank” of the Slaintecare reform programme for the health service.

He said the report is a “very realistic appraisal of the difficulties which such a reform will involve, and sets out a realistic timetable for this objective”.

The news of Mr Harris’s assurances to Mr Donohoe comes in the aftermath of their Departments announcing a new Slaintecare contract for consultants, the provision of which had been a marquee recommendation of the De Buitléir report.

Under that contract, from the second quarter of this year, all new consultant appointments will be offered at a starting salary of €222,460. At present the starting salary for consultants is some €90,000 shy of that figure, a fact that is broadly believed to be behind the more than 700 consultant vacancies in the system at present.

However, the new contract is predicated on those new hires focusing 100% on public-only work.

Per the De Buitléir report, which predicted a 10-year timeframe would be required to entirely remove private care from the public service, the total cost per annum of such a move would be €659.6m per annum once the process was completed.

Some €48.6m, or 7%, of that figure is represented by new consultant contracts, albeit De Buitléir asserted a starting salary of €182,000, which is €40,000 less than the figure envisaged by the Government per last month’s announcement.

It’s believed the total projected bill to the Exchequer of removing private care from the public service would be in the region of €1.5bn after 10 years.

A spokesperson for the Department of Public Expenditure said that the request for assurances that De Buitléir’s recommendations would be non-binding is “usual process” given the membership of the review group which compiled the report, while “subject matter experts”, “may not have had wider public service, budgetary or Exchequer-related considerations in mind when making their findings”.