The board of the Rotunda Hospital is standing by its decision to allow public-only consultants to continue offering private care.
Following a meeting on Friday, the board is now seeking a meeting with Minister for Health Jennifer Carroll MacNeill to discuss “the rationale and impact” of its decision
In a statement the board said: “The Board of the Rotunda met today to discuss the September 2024 board decision to continue to allow private practice for Public Only Consultant Contract (POCC) holders, and to consider the merits, risks and consequences of that decision. This discussion was also informed by current Department of Health and HSE direction and correspondence on this issue.
“In all of its deliberations, the board’s overriding priority is to ensure that every patient receives the best possible care, regardless of whether they are a public or private service user.
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“The board has written directly to the Minister for Health this afternoon to seek a meeting to explain the rationale and impact of this decision, and to seek a way forward to resolve this issue for the common good of all patients.”
Earlier, the Minister for Health said the Rotunda may owe refunds to women who received private care from consultants working under public-only contracts.
Carroll MacNeill also said there could be an issue with the Rotunda continuing to be covered by State-funded clinical indemnity insurance if it continues to allow public-only consultants to offer private care.
She said there was an “open question” about insurance issues that the oldest and busiest maternity hospital in the State might face if it continues to flout Government policy.
[ Rotunda row pits public against private health careOpens in new window ]
The issue came to light after Prof Seán Daly, master of the Rotunda, told the Oireachtas health committee last week how the hospital was allowing public-only consultants to continue to treat patients on a private basis.
In a sharp rebuke of Daly, the Minister declined to express confidence in the consultant obstetrician and said she believed women who have paid for private care from Rotunda from consultants who were on public-only contracts should be refunded.
She said the HSE had sought details from the hospital on the number of women “who paid private consultants to receive a private service in the Rotunda, that the Rotunda was not contractually capable of giving. I think it’s important that those women are recompensed, and we have asked for those details”.
The Rotunda has until Monday to provide the HSE with an audit detailing how many consultants have been continuing to offer private care while on public-only contracts, and how much of this care the Rotunda has billed for. Failure to do so could trigger a process under the Rotunda’s service-level agreement with the HSE that could result in funding being withheld or withdrawn.
Speaking on RTÉ Radio 1, Carroll MacNeill said she expected compliance from consultants who were “paid richly” on public-only contracts.
The master of the National Maternity Hospital at Holles Street backed the Rotunda by calling on the Government to consider allowing new consultant obstetricians to remain on public-private contracts. Prof Jennifer Walsh said her hospital is receiving “formal complaints” from women who cannot book private care with a consultant who has retired and possibly been replaced by a colleague on a public-only contract.
She said she was not in favour of consultants on “well compensated” Sláintecare contracts being allowed to continue offering private care, which is the policy the Rotunda is pursuing.
“But perhaps you leave people on the older contracts. Perhaps if a ‘B-contract’ holder retires, they’re replaced with ... a B-contract holder,” Walsh said.
A type-B contract is one that allows a consultant obstetrician to carry out public and private care within a public hospital.
“I’m not a policymaker; I’m a clinician,” Walsh said. “This isn’t a clinical problem; it is a policy issue. But I do think we need to hear what the women are saying.”
She said women not being able to access private care in maternity hospitals was an “unintended consequence” of Sláintecare.
In a statement to The Irish Times, the National Maternity Hospital said it is seeking a “derogation” for its consultants to be allowed to continue offering private care on site in its largely publicly-funded hospital.
“The National Maternity Hospital (NMH) can confirm that since the public only consultant contract (POCC) came into effect, all consultants on a POCC provide care to public patients only in the NMH,” it said.
“The NMH agrees with the principles of Sláintecare. However, women’s voices and concerns need to be heard. The solution lies in a derogation from the POCC that will allow for the provision of private obstetric care in maternity hospitals, giving women that choice.”
The Rotunda, like all maternity hospitals, is covered by Clinical Indemnity Insurance, which is offered by the State Claims Agency. This covers consultants on public-private contracts who offer private and semi-private maternity care at the hospital.
A spokesman for the State Claims Agency said this insurance applies to the entire hospital rather than individual consultants, so “the indemnity applies in respect of all consultant doctors, irrespective of the contract he or she holds”.
