Madam, - Like many hospital consultants I am irritated by the constant suggestions in the media that we do not provide a good service to public patients. The cost of health care is high but the constant suggestion that by preventing private practice the problem would be solved is ridiculous.
Prof Niamh Brennan has suggested that consultants should devote themselves to either full-time private or public service and not to the mix that currently exists. It has also been suggested that consultants delegate work to junior medical staff, by implication the consultants not being available because they are carrying out private work.
Public hospitals are expected to generate approximately 15 per cent of their revenue from private patients. If this practice were stopped, this revenue would have to be replaced by the Department of Health!
What some might call delegation of work to junior medical staff is in fact the process we doctors call "training". If consultants did all the work, the next generation of doctors would be untrained. Where, then, would the large numbers of extra consultants, proposed by the Government as their solution to the problems in the health services, be found?
Hospital consultants are paid for both their public and private work. We are not partners in a business. What we earn is generated solely by our own activity. That consultants work very long hours can be attested to by their families, as are the many sacrifices that have been necessary during the course of training to develop the specialised skills that are expected of a consultant.
Most consultants (90 per cent) are employed on Category 2 contracts, which entitle them to carry out both public and private practice. There are very few consultants in full time private practice. To prevent hospital consultants from treating private patients would deny a significant percentage of the population access to the highest level of medical expertise. This would discourage people from taking out private medical insurance, which was, after all, started by the Government, and increase the burden on the public health service. I cannot see how this would benefit the public coffers.
Prof Brennan has advocated commitment by doctors to either the public or the private health service. Can we assume that she will be resuming full time academic activity, as it would seem disingenuous for a tenured university professor to devote so much time to Government "think tanks" instead of pursuing academic activities? It seems unfair that the academic world should be deprived of the full attention of one of its luminaries.
Perhaps the academic goose should try the same sauce that she suggests for the medical gander? - Yours, etc.,
PETER O'ROURKE,
FRCSI (Orth.),
Letterkenny General Hospital,
Letterkenny,
Co Donegal.