Private doctors warn proposed Covid contract will create new public waiting list problem

Thousands of private patients could end up on public hospital waiting lists if ‘private only’ doctors accept a temporary contract to work exclusively for the HSE as part of the Covid-19 response.

That’s according to the Irish Hospital Consultants Association (IHCA), which is seeking legal advice on a contract being offered by the Department of Health and HSE to around 500 consultant doctors, who work exclusively in private practice.

Plans by the Department of Health to temporarily take over 19 private hospitals to boost the capacity of the healthcare service to deal with the Covid-19 outbreak have hit a snag due to differences over the terms and conditions of the temporary Covid contracts being offered.

Doctors working exclusively in private hospitals raised concerns over proposals that would effectively see them moving from treating ‘private only’ patients to treating ‘public only’ patients.

The doctors say the HSE contract, as currently drafted, would create new waiting list problems as it would prevent them from treating private patients, who would ultimately be referred back to their GPs and onto public hospital waiting lists.

More than 500,000 people are currently waiting for an outpatient appointment in the public healthcare system.

Dr Oisin O’Connell, a respiratory consultant at the Bons Secours private clinic in Cork, told RTÉ Radio that doctors working in private practice were ready to put on the ”medical green jersey” but had issues with a contract that would effectively close their practice and create further waiting list problems for the public health service.

The proposed contract, he said, left private practitioners with an “ethical dilemma”.

“I want to work frontline, I want to look after Covid patients. I think this is a national emergency but similarly I’m left in an ethical dilemma that if I do that, and accept the contract, I have to cancel all my clinic patients,” Dr O’Connell told the Today with Sean O’Rourke programme on Monday.

I’m following up on 2,500 complex respiratory patients, 500 of whom are suspected to have lung cancer, so it’s very difficult to put them on a public waiting list of 560,000 people.

"I’ve already set a precedent with these patients that I’m following them up. I’ve already got their scans booked. I’m now being told, as of this morning, I need to cancel that follow up, refer them onto another hospital, who will put them in their system,” he explained.

The IHCA, which represents the majority of hospital consultants in the country, said one-third of all outpatient appointments were seen by ‘private only’ consultants every day and that the proposals could have “considerable knock-on detrimental impacts” on all patients accessing hospital services.

IHCA members say they are willing to sign up to a 39 hour week working for the HSE but also want to be able to treat private patients outside of that commitment.

“I’m hoping the HSE will engage with the IHCA and negotiate a way that we can continue to provide continuity of care for our patients and work front and centre. I’m very happy to do both,” Dr O’Connell said.

“I’m not here to profiteer in any capacity. I’m completely happy to put on the medical green jersey but I can only assume that this was an unintended consequence that wasn’t foreseen but it is going to cause massive issues on the frontline,” he added.

The temporary contract was initially envisaged to be for three months but the Irish Examiner understands the contract sent to doctors on Monday morning is open-ended and does not specify a time period.

For insurance reasons ‘private only’ doctors cannot currently assist with the Covid-19 response unless they sign a contract to work in the HSE.