MINISTER FOR Health Mary Harney said yesterday she didn't understand why the loss of income for public hospitals from the new consultants' contract was now a budgetary issue for the Health Service Executive as she had warned them in advance.
Her comments to nurses at the annual conference of the Irish Nurses' Organisation in Killarney came a day after the HSE's chief executive Prof Brendan Drumm told the Dáil Public Accounts Committee that the HSE had not foreseen that its income would be down around €50 million this year.
The decline is a result of the fact that insurance companies cannot be billed for the treatment of patients admitted to hospital under doctors who have new public-only contracts, even if the patients they admit have private health insurance. This new so-called black hole in the HSE's finances was described as a "cock up" by INO general secretary Liam Doran yesterday, who pointed out that the money lost would employ an extra 1,000 nurses in the public health service.
However, Ms Harney stressed there was no "cock up" as the loss of income was the result of a deliberate policy pursued by her to ensure public patients had more equitable access to public hospitals.
"I don't understand the budgetary issue. I wrote to the HSE in relation to this matter, so there shouldn't be any doubt about it," she said. "I made it clear to the HSE that they could not charge for patients that were being treated by doctors that had a full-time public salary," she added.
"This is all about greater access, equality of access for our public patients and not incentivising hospitals to take one set of patients over and above another," she said.
Furthermore, she said the HSE had already got more money from the VHI in the first few months of this year than over the same period last year. The VHI confirmed this. It said it paid €73 million to the HSE in the first three months of this year compared to €60 million in the first three months of last year.
However, Prof Drumm insisted that it was very difficult to anticipate this loss of income would be the end result of the new public-only consultants' contracts after four years of negotiation. He said the HSE had got different advice on this than the Department of Health.
This issue was also discussed at the annual conference of the Irish Medical Organisation in Killarney last month where it was stated that internal correspondence between the HSE and the department earlier this year indicated the loss of income from the new public-only contracts to the HSE was nearly €70 million for the first few months of this year alone.
Meanwhile, Ms Harney got a cool reception from the nurses when she urged them to separate their personal grievance in relation to the pension levy from their professional concerns about patient care in the face of cutbacks. The nurses voted on Thursday to take whatever action is necessary, including all out industrial action, to protect their pay and to ensure safe services were maintained. The Minister told them the HSE was facing huge challenges in this unprecedented economic climate, but said "if we are all flexible and innovative and open-minded and work together", we can continue to provide the services patients expect for the money invested.
INO president Sheila Dickson stressed nurses, midwives and ordinary workers were "absolutely blameless" for the current recession, citing lack of regulation of financial institutions, reckless banks and Government policy as the ones who were to blame. She said Ms Harney and the Government had failed to explain "why we must spend billions on saving banks and financial institutions while we cannot spend less than €10 million on a cervical vaccination programme for young girls . . . not only does it appear unequal, not only does it appear that the Government is looking after the elite, it is unequal and you are looking after the elite and that is wrong".
Ms Dickson went on to lambaste the Government's embargo on recruitment, describing it was "a weapon of mass destruction in the public health service".