State takeover of private hospitals to be reviewed at end of May

The Government’s initiative to take over nearly 20 private hospitals will be reviewed before the end of the month to assess its effectiveness in supporting the public health system and in the context of the prevalence of Covid-19, a confidential Department of Health/Health Service Executive paper has said.

The document, given to the National Public Health Emergency Team (Nphet) on Tuesday, stated, given the costs involved, any extension of the current agreement would require the approval of Minister for Public Expenditure Paschal Donohoe.

Taoiseach Leo Varadkar told the Dáil in April the agreement with the private hospitals could cost €115 million per month.

In a report to Nphet on the provision of non-Covid care in hospitals, the Department of Health/HSE said that, subject to guidance on mitigating risk in carrying out procedures, it was envisaged the private hospitals would be used in support of the resumption of more routine scheduled care in order to tackle the increasing waiting lists for such care.

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Service-level agreement

However, the paper warned that “this may be dependent on the decision on whether or not to extend the arrangement”.

“Implementing the arrangement between the HSE and the private hospitals has been a slower process than originally anticipated. The finalising of the service-level agreement with individual or groups of hospitals has proved to be more complicated than was originally envisaged. However, it is expected that service-level agreements will be concluded with the hospitals shortly. The process of offering the consultants who work wholly for the private sector locum public-only contracts for the duration of the arrangement has also proved to be complex.”

The Government's deal with private hospital did not encompass about 600 consultants who practise in these facilities. The Department of Health said that so far about 280 have signed a proposed contract which would see them treat public patients only.

Cost-only model

Minister for Health Simon Harris is expected to meet private hospital consultants on Friday.

Mr Harris told the Dáil on Thursday that payments to the private hospitals “will be a cost-only book model, whereby the hospitals will be reimbursed only for the operating costs property incurred for the period”.

The costs covered will be limited to normal cost of operating the hospital.

The paper given to Nphet also said the HSE had identified the need for “significant additional investment” to augment infection and prevention control (IPC) resources to sustain current services as hospitals return to normal activity, and for the rollout of an ICT system across all acute hospitals to increase efficiency in infection surveillance.

The paper also said the Department of Health would “engage with [the health safety watchdog] Hiqa and the HSE in relation to the potential to undertake a review of IPC control capacity in private hospitals”.

It is understood that in April Hiqa carried out a desktop review of infection control in acute hospitals and identified a number of potential risks.