A process is under way to ensure the practice of medical consultants on public-only contracts doing “nixers” for private consultants “ceases with immediate effect”, the Tánaiste has said.
Simon Harris said in the Dáil a process is under way led by the HSE chief executive, going “regional health area-by-regional health area, hospital-by-hospital, to make sure there is full compliance”.
A maternity consultant on duty in any hospital “is responsible for the care of all patients requiring attention, regardless of whether they’re private or public”, he said.
The Government and the Minister for Health Jennifer Carroll MacNeill have shown any breaches “simply won’t be tolerated”, he warned.
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Harris was responding to Social Democrats deputy leader Cian O’Callaghan, who highlighted a series of revelations about alleged breaches of public-only contracts in a number of hospitals.
He cited an Irish Independent report about a long-standing “professional fee arrangement” that has been in place among Cork University Hospital consultants. Hospital management said it “plays no part” in a “private professional arrangement between some consultants”.
O’Callaghan understood this practice has been stopped in Cork from this week but there was no such confirmation from the Rotunda hospital, where the controversy first emerged about public only consultants treating some private patients.
He also highlighted problems at Galway University Hospital where public consultants “are being asked by management to do lab work for a private hospital”. “While some are refusing to do this it is nonetheless leading to huge delays” in tests for life threatening conditions including cancer, he said.
The Dublin Bay North TD said this had led to lab work being outsourced to commercially run labs at “enormous expense to the public purse” and it was “having a real and negative impact on the care of public patients” and he asked what was being done to enforce public only contracts.
The Tánaiste said a process was under way, that he had been briefed on at the Cabinet Committee on Health, in each HSE health region and hospital to make sure there is “full compliance” with the public-only contract.
The idea a consultant on call has to be given “some sort of gift or payment” to see a patient is “not how it works. And doctors know that too.”
Crossover between consultants is routine and an expected part of the delivery of public health services. “Any suggestion of private financial arrangements” is “inconsistent with contractual obligations, raises serious concerns and risks diverting time and resources away from treating public patients”.
He also stressed “the idea of anybody being given a gift or paid to do a nixer effectively, is not in line with the contract, is not an approved HSE arrangement”.
The Government would not “condone” it and “measures are now being taken to ensure that this practice ceases with immediate effect”.
As Minister for Finance he also wanted to say “any income direct or indirect, gained from employment is taxable. An Revenue have standard audit compliance procedures which they operate across all sectors.”
He added: “So whether it is payment the traditional way, or a gift, or a nixer, please be aware of the taxable obligations on any income derived through that.”
