Hundreds of consultants flout contracts

PUBLIC ACCOUNTS COMMITTEE:HUNDREDS OF hospital consultants are flouting the conditions of their new contracts by treating too many private patients, the Dáil Committee of Public Accounts heard yesterday.

The contracts set strict limits on the numbers of private patients permitted to be treated by consultants working in public hospitals.

However, the committee heard the HSE had written to 85 consultants because they had been exceeding the ratio of private to public patients under their contracts. The ratio of public to private patients treated in public hospitals should be 70:30 or 80:20, depending on the type of contract held.

Some 86 per cent of the State’s 2,350 consultants have signed up to the new contracts. Some 682 signed up to the contract that excludes private work, while 1,343 agreed to contracts with the 80:20 or 70:30 public-private ratio.

The committee met HSE chief executive Prof Brendan Drumm, the department secretary general Michael Scanlan and their officials to hear about progress in implementing the contracts yesterday.

Prof Drumm said “a lot more” consultants would be written to in the coming months over treating too many private patients.

He said hundreds of consultants were involved but there were strict sanctions for consultants who broke the terms of their contracts. If consultants do not take action within a certain period of time, they face forfeiting their fees for the additional private patients.

Labour’s Róisín Shortall described the scenario as “damning” and “very disappointing”.

Prof Drumm agreed to a request from committee chairman Bernard Allen that he would provide the committee with details of the public/private case mix for all consultants in the coming weeks.

Fianna Fáil deputy Seán Fleming took issue with the fact that a Category A consultant, who can only do public work, could still get paid extra for providing reports, such as accident reports.

The committee also heard that €376 million had been lost to the State because charges for private care were not recouped when private patients were placed in public beds.

Fianna Fáil deputy Michael McGrath raised the question and said: “Taxpayers are paying a subsidy of up to €400 million in respect of private patients in the public hospitals system – that’s the bottom line.”

Committee chairman Bernard Allen said public beds were being blocked by private patients “because the consultant is getting paid anyway. The public hospital isn’t getting paid. The taxpayer is suffering and the public patient is suffering”.

Prof Drumm also pointed to “major logjams” in the payment of hospital accommodation costs by insurers. It takes on average, six months, from the discharge of the patient to the payment of the fee by the insurer.