Elimination of private care in public hospitals to be proposed

Period of six years to disentangle public and private healthcare, says Oireachtas group

The Oireachtas Committee on the Future of Healthcare is on Tuesday expected to sign off on a report recommending the phased elimination of private care from public hospitals.

However, in a late amendment, the group is proposing an independent impact analysis of the separation of private practice from the public system to identify any “adverse or unintended consequences” for the public system.

"It is imperative that any change should not have an adverse impact on the recruitment and retention of consultants and other health professionals in public hospitals," according to the executive summary of the report, seen by The Irish Times.

The “disentanglement” of public and private care is now envisaged to take place in six years, up from five years in earlier drafts. Public hospital activity will be expanded by “undoing” two-tier access, increasing access to diagnostic tests in the community, reducing waiting lists and removing private care from public hospitals.

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‘Equity of access’

“This will mean that all patients will be treated on the same, public basis in public hospitals, ensuring equity of access for all based on need rather than ability to pay,” the summary states.

No one should wait more than 12 weeks for an inpatient procedure, 10 weeks for an outpatient appointment and 10 days for a diagnostic test, it proposes. Hospitals that breach guarantees will be held accountable through sanctions and other measures, “but not to the detriment of healthcare delivery.”

The committee considered various funding models and decided in favour of one where private health insurance “will no longer confer faster access to healthcare in the public sector, but is limited to covering private care in private hospitals”.

Universal healthcare

The plan envisages increased investment of €350-€400 million a year, for six years, to deliver universal healthcare. An additional €3 billion will also be needed for capital investment, transitional arrangements and for dealing with legacy arrangements.

The report, when finalised today, may also include a reference to the need to separate Church and State in healthcare and to the need for support for a process of divestment of religious-owned facilities in the area.

It is expected to win the backing of the vast majority of the committee's 14 members, with only Solidarity's Mick Barry certain to oppose the final report.

The report will be launched by committee chairwoman Róisín Shortall in the presence of party leaders at the end of the month.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times