Consultants face penalties on private practice ratios

THE HEALTH Service Executive (HSE) is to warn a number of hospital consultants this week in writing that they face having financial…

THE HEALTH Service Executive (HSE) is to warn a number of hospital consultants this week in writing that they face having financial penalties imposed on them for treating too many private patients.

The new consultant contract stipulates that the ratio of public to private patients treated by doctors in public hospitals should range between 70:30 and 80:20 depending on the type of contract held by each doctor.

If private-practice rates persist at levels above the official thresholds, there is provision in the new contract for consultants to face financial penalties.

For some time now the HSE has been sending warning letters to some consultants, maintaining that they are breaching their contracts by treating patients in excess of the official threshold and urging them to bring the ratios into line.

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The HSE said last night that the letters would be sent to consultants in cases where private practices levels were consistently above 40 per cent.

The Irish Hospital Consultants Association has strongly challenged the methodology under which the HSE calculates the level of private practice and has rejected claims that consultants are in breach of their contractual terms. In letters to be sent out this week, the HSE will warn for the first time of the imposition of financial penalties.

Under the terms of the contract consultants who are consistently in excess of the permitted private practice levels can be asked to contribute money earned above the official limits to a research fund in their hospital.

The money would not be given to the HSE corporately.

In a statement last night, the HSE said it could confirm that it was currently writing to a number of consultants in relation to contractual issues. It declined to comment further on the issue.

Assistant general secretary of the Irish Hospital Consultants Association Donal Duffy said last night that his organisation had told an Oireachtas committee earlier this year that there were “significant failings” in the system used by the HSE for measuring consultants’ public and private work.

“The HSE has not addressed these failings and any question of penalties is premature”, he said.

Last May The Irish Timesrevealed that more than 200 consultants across the State had, at that stage, been formally warned they were seeing too many private patients in public hospitals.

Internal HSE documentation published at that time also revealed that compliance in some hospitals with the new contracts had deteriorated during 2009.

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.