Crucial votes on proposals to eliminate private practice from public hospitals are due this week at the Oireachtas Committee on the Future of Healthcare.
The committee, which is tasked with producing a blueprint for reform of the health system over 10 years, is meeting for four hours on both Tuesday and Wednesday mornings in an effort to agree its final report.
Draft reports produced by the committee secretariat have proposed the complete elimination of private practice in public hospitals, though Fine Gael and Fianna Fáil TDs have expressed reservations about such a major change. Currently most consultants are allowed to combine their private practice with their public work.
Last week, Fine Gael and Fianna Fáil TDs joined forces to block a proposal in the draft report to abolish tax relief for private health insurance premiums, voting to excise the provision from the final report.
Blueprint
TDs on the cross-party Oireachtas committee have worked together since last summer to produce the blueprint for systemic reform of the health service, but as the deadline for finalising the report approaches, Fine Gael and Fianna Fáil TDs have become wary of recommendations which would totally separate the private and public systems.
Some 45 per cent of people have private health insurance cover, enabling them faster access to some treatments, many of which are delivered in public hospitals by doctors who serve both public and private patients.
The draft reports have recommended that the public and private systems be “completely disentangled”.
Some members of the committee are also nervous about proposals which would require a big expansion in the health budget.
Expansion
The report says that revenue stream from private insurers to public hospitals – more than €600 million a year – would have to be replaced by public funding. This would be part of a much larger expansion of health service budgets, funding new staff, new facilities and greater access to services for public patients.
However, those on the committee who favour the separation of the public and private systems say that they fear that Fine Gael and Fianna Fail may keep the aspiration to “disentangle” the two systems, but will water down many of the actions required to achieve this.
“The danger is they will turn it into a dog’s dinner,” said one committee member.
Fine Gael and Fianna Fáil members say privately that they see little point in producing a report which demands huge additional spending on health which no future government will be able to afford.
The committee will also consider proposals from Sinn Féin health spokeswoman Louise O'Reilly under which the Minister for Health would be made "legislatively accountable for the delivery of health services", according to the latest draft, seen by The Irish Times.
