HSE proposes taking over 40% of activity in private hospitals

Any new agreement to tackle Covid-19 surge could run for two years

The HSE is seeking to take over up to 40 per cent of activity in private hospitals, potentially for two years, to deal with further surges in Covid-19 cases.

Under its proposals the HSE is seeking private hospital facilities to provide “time-dependent” complex medical and surgical treatment for public patients in a non-Covid environment.

However, in some cases patients with Covid-19 would be treated in private hospitals.

The HSE said on Friday it was “engaging with private hospitals to provide services at a number of different levels”.


The HSE did not answer questions on how many private hospitals had so far agreed to its proposals. However within the private hospital sector it is believed by senior figures that few, if any, have signed up so far.

The HSE said it was in talks with the private sector on a “safety-net agreement for activation in the case of a further extreme Covid-19 surge in the near future”.

It also said it had tendered for private hospitals to provide different services such as provision of in-patient treatment and care for time-dependent and urgent care, inpatient scheduled care such as orthopaedics, outpatient services and access to diagnostic services.”

Members of the Medical and Dental Consultants Association, a new organisation set up recently which represents specialists in the private sector, expressed unhappiness at the proposals. It maintained they were "poorly thought out" and did not fully grasp that private hospitals were currently operating at full capacity and were dealing with patients with conditions that were equally as complex as those in the public system.

Guaranteed access

The HSE is not seeking to take over fully private hospitals as it did in the spring. Instead it is looking for an accord which would provide for guaranteed access on a pre-agreed basis to 40 per cent of the typical in-patient and day-case activity levels on a graduated basis.

The HSE is seeking an “all inclusive” package of care to be provided, including the services of doctors in the private hospital . This would be paid for in an overall fee based on the average cost for similar procedures in the public system based on consumables and staff costs.

It would be up to the private hospital to make arrangements for such an overall package of care. The HSE would not have a direct contractual arrangement with consultants.

However, the HSE is understood to want provision to send some of its own clinical or other staff to private hospitals to deal with a particular service requirement.

It is understood the proposals envisage that where a public patient was treated as a private patient, any income received from a health insurer would be offset against the bill paid by the HSE.

Patients who are liable for statutory public hospital charges would be billed for these by the private hospital.

The HSE has proposed any new agreement would run for 24 months. However, there would be a review after a year which would look at developments, including treatments or the availability of a Covid-19 vaccine.

Infection rate

Among the measures that would lead to a triggering of the HSE proposals would be the national Covid-19 infection rate in the community, the level of hospitalisation and ICU occupancy.

Most private hospitals contacted on Friday declined to comment.

The Bon Secours Health System said:"Discussions have been ongoing intermittently for months on a second wave, and were escalated this week by the HSE. Any agreement would need the approval of our board and the commitment of our consultant colleagues."

Martin Wall

Martin Wall

Martin Wall is Washington Correspondent of The Irish Times. He was previously industry correspondent