St Vincent’s group threatens ‘legal battle’ with HSE

The board of St Vincent’s Healthcare Group, which runs two of Dublin’s main hospitals, has threatened a “legal battle” with the HSE if more than 100 of its consultants are prevented from carrying out private work.

The board has also ended its involvement in a plan to provide management assistance to hospitals in Wexford, Loughlinstown and Kilkenny because of the escalating row with HSE director general Tony O'Brien. It has already put on hold the planned transfer of the National Maternity Hospital to the St Vincent's campus because of the dispute.

The deterioration in relations between the board and the HSE, and especially Mr O'Brien, is revealed in correspondence between the two sides over the past six months, seen by The Irish Times. Board chairman Jimmy Menton, in a letter to Mr O'Brien last month, claimed the "personal approach" of the HSE boss was based on "aggression, threats and unsupported allegations, which are causing significant disquiet throughout our hospitals . . . We can put up with this no longer".

‘Disingenuousness’

Mr O’Brien, for his part, has accused the hospital of having a “background of disingenuousness” and has questioned the viability of the private hospital at St Vincent’s.

Speaking at the Dáil public accounts committee in April, Mr O’Brien said there were serious outstanding governance issues at St Vincent’s and half the consultants in the private hospital were not permitted to work there. He claimed the private hospital was being run “on the back of” the public hospital and suggested the public hospital may be at a loss because of this. He has since commissioned external forensic auditors to review the group’s financial arrangements.

His comments prompted an angry response from Mr Menton, who wrote to the HSE boss on May 6th calling on him to validate or withdraw his claims.

“To make such damaging allegations in a privileged environment, knowing that they would be broadcast widely and cause damage to the reputation and standing of St Vincent’s Healthcare Group, is a remarkable action . . . and one that we struggle to understand.”

St Vincent’s says it has legal opinion that the consultants’ contracts are valid. Mr Menton has told staff no public monies are diverted to the private hospital. He says the public and private hospitals, while complementary, are run entirely separately.

The group says the 106 category B consultants have threatened legal proceedings if any change is made to their terms of work, as demanded by the HSE. Category B consultants are allowed to do limited private work on their public hospital campus, including a co-located hospital, but not in other private hospitals.

Co-located facility

St Vincent’s argues its consultants are covered for working in the private hospital because this is a co-located facility on the same campus. The public and private hospitals are connected by a tunnel.

It applied to have nine consultants switch to category C contracts, which would allow them work in other private hospitals. However, Mr O’Brien sought details of all consultants’ public and private work before agreeing.

He also told Mr Menton there was “room for concern” about the “onward viability” of the private hospital, given the dependency on category B consultants, its beds, the high ratio of beds to theatres and “the overall economics of private healthcare in Ireland currently”.

St Vincent’s says data protection means it cannot provide detailed information on the work of consultants in the private hospital.

The dispute has escalated to Minister for Health Leo Varadkar, whose department will seek to convene talks between the two sides.