Consultants told: give half of private fees back to HSE
Published 04/10/2010 | 05:00
PUBLIC hospital consultants earning collectively in the region of €350m a year in fees from insured patients should give half their private income back to the cash-strapped health service next year, a leading health expert has said.
Around 1,650 consultants who are on generous public hospital salaries can boost their earning power by also treating private patients.
But Anthony Staines, a professor of health systems research at Dublin City University, has told consultants that a levy in the region of 50pc should be put on their private income.
It would mean they would give half their private fees to the public hospital they work for or the Health Service Executive (HSE), and they would be taxed as normal at 40pc on the rest.
While no official figures exist on the amounts earned by public consultants who are also allowed to treat private patients, the sum is probably in the region of €350m.
Speaking at the annual meeting of the Irish Hospital Consultants Association (IHCA) in Limerick on the weekend, Prof Staines also called for a sharp cut -- or abolition -- of the state subsidies to private patients, including the €260m in tax reliefs for private health insurance premiums.
Public hospitals treating private patients are losing out to the tune of €50-€100m, he said. "None of this is good use of public money . . . it should be stopped today."
Prof Staines said he was recommending "drastic action" -- and warned that with massive cuts in spending due next year, the health service is in "absolute crisis" with a loss of vital frontline staff.
His predictions of swingeing cuts were echoed later by Health Minister Mary Harney, who conceded the budget could be slashed by even more than the €600m already feared.
However, no decisions have yet been made, she stressed.
Patients would suffer if this level of funding was taken from services, but this could be averted if the Croke Park agreement allowing for redeployment of staff and other efficiencies was implemented, she claimed.
Asked if hospital consultants would be willing to donate half their private income as suggested, IHCA secretary general Finbarr Fitzpatrick described the idea as "hare-brained".
He said if doctors were levied in this way it would be necessary to impose similar levies on other professionals employed by the State who earn private income.
Only around 620 consultants in public hospitals have signed up to contracts which prevent them doing any private work.
Prof Staines said the HSE could also make savings by sharing office services among voluntary bodies contracted to provide support in areas like disability, and also in restricting drug lists.
Currently, a doctor is allowed prescribe any drug and that is "mad", according to Prof Staines.
Meanwhile, it emerged yesterday that the HSE is looking at introducing a new system of financing non-emergency operations.
It is expected to pilot a system in some hospitals next year which would see the hospital paid per procedure -- thus ending the current arrangement whereby a hospital gets a block grant.