Coronavirus: Private medical consultants seek clarification on HSE contracts

There is still no agreement between the Government and about 600 medical consultants working in the private sector over plans to bring them into the public system to help deal with the coronavirus pandemic.

The Irish Hospital Consultants Association (IHCA), which has advised its members not to sign a proposed new contract put forward by the Health Service Executive, said on Monday it was seeking further clarifications on the proposals.

It said it also wanted to “agree a time frame and related provisions for such arrangements”.

Further engagement between the IHCA and the HSE is expected in the coming days.

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The association said said full-time private-practice consultants would continue on a voluntary basis “to deliver urgent inpatient care and continue to provide time-critical essential care from consulting rooms to permit an opportunity for agreement on the proposed contract without further delay”.

However, the IHCA also maintained that consultants and patients needed certainty as the current impasse was “untenable”.

The Government has already effectively taken over the beds and facilities in 19 private hospitals as part of its plans for dealing with the Covid-19 pandemic.

The Government also wanted to bring up 600 consultants who work fully in the private sector into the public system in parallel. It offered them a locum contract under which they could see only public patients with a salary that ranged from €141,000 to €195,000.

The private consultants expressed concern about thousands of existing private patients who are already on their books if they moved exclusively into the public system . This is known as the “continuity of care” issue.

On Friday, the HSE tabled revised proposals to allow private-sector medical specialists treat their existing fee-paying patients in the public system on condition they did not charge them.

The HSE also indicated it could pay to use private rooms which consultants may have outside of private hospital premises if such arrangements were deemed necessary and represented value for money.

Income supports

The HSE said staff and others currently directly employed by private consultants in off-site rooms could benefit from the income supports provided by the State, as appropriate.

The IHCA said on Monday an understanding had been reached on April 8th “which provided for both existing patients of full-time private-practice consultants and new referrals necessitated by the Covid-19 emergency to be cared for on an agreed basis including the continued operation of consulting rooms”.

“However, this did not materialise in the written updated draft contract circulated by the HSE on 10 April 2020.”

The IHCA said if the current version of the proposed contract was to come into effect “consultants would be liable for costs which would likely exceed their income, thereby forcing the closure of consulting rooms needed to provide timely outpatient care”.

Some senior IHCA figures suggested over the weekend that under the most recent HSE proposals consultants would have to pay themselves for the cost of operating private rooms as well as staff expenses, although not receiving fees.