HOSPITAL CONSULTANTS are routinely breaching rules that limit the extent of their private practice in public hospitals, according to a Dáil committee report into health service spending.
It is one of a series of highly critical findings by the Public Accounts Committee, which examined whether the €12 billion in taxpayers' money spent on health and social care services is being used efficiently.
The committee chairman, Fine Gael TD Bernard Allen, said the 80/20 split for private practice in public hospitals as set out in consultants' contracts was being ignored extensively across the board. "When we looked for information on private-public mix, we were told it could not be made available to us because of contractual arrangements," he said. "We find that hard to take. It's quite horrifying in an area where taxpayers' money is involved," he said.
He said the Health Service Executive, the former health boards and the Department of Health were to blame for failing to enforce the limits on private practice.
Other areas identified by the committee where health authorities have failed to monitor costs or allowed wasteful spending to continue include:
• A failure by the HSE to keep a comprehensive list of the properties it owns, as well as underutilising of assets such as three community homes in Castlepollard which were bought for €640,000 in 2001 but never used;
• Widespread overprescription of drugs by GPs, especially branded drugs and antibiotics;
• A lack of ethical guidelines preventing family doctors from accepting incentives from pharmaceutical companies for prescribing branded drugs, such as golfing holidays and free gifts;
• The high level of subsidies available for private hospital beds in public hospitals, despite repeated pledges by the Government to end the practice.
The National Treatment Purchase Fund (NTPF) was also heavily criticised on the basis that public patients waiting for treatment were often treated by the same consultants in a private capacity. Committee members said they were unable to get details of the fees charged by consultants under the NTPF, or arrangements that existed with health insurers.
Labour's Róisín Shortall TD said the situation was intolerable and needed to change urgently.
Mr Allen added: "I am not happy at all that the NTPF is giving taxpayer value for money. I am not happy if our acute hospitals are overstretched that there could be such flexibility within the system to allow private work be done in a private capacity by consultants. It's a double payment for the same job. We are concerned about patients on public waiting lists being transferred to the same consultant to carry out work in another hospital. We believe that there is a need for a more detailed investigation of the NTPF."
Yesterday's report, compiled on the basis of evidence from the chief executives of the HSE and NTPF and the accounting officer of the Department of Health, contains a series of recommendations on tackling wasteful health spending. The committee is expected to seek a progress report from health service chief executives in the next six months.