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Friday 19 January 2018

Consultants refuse to pay fines for breaking private practice quotas

Eilish O'Regan Health Correspondent

A GROUP of 70 highly paid hospital consultants have refused to comply with a HSE demand to hand back thousands of euros in fees as a penalty for treating too many private patients.

The ultimatum was issued by the HSE last June after a group of consultants, some of whom earn €400,000 a year, failed to honour contractual obligations to confine their private patients quota to 20-30pc of their workload.

The quota was introduced by the last government in an effort to reduce the numbers of public patients on hospital waiting lists.

However, a group of 70 doctors were found to be devoting in excess of 40pc of their workload to private patients.

The consultants were given until September 15 to pay back a percentage of their private patient fees as punishment for exceeding their quotas.

The HSE warned that if they did not do so they would be barred from taking any further private fees.

The Irish Independent understands some of the consultants have been ordered to repay up to €20,000.

However, with the deadline looming, none of them have paid even a cent of the penalty.

The doctors agreed to higher salaries of up to €183,500 for treating public patients three years ago in return for limiting their quota of private patients.

In addition to this salary, many of the consultants are topping up their pay with another €200,000 in private patient fees, according to figures from the VHI.

When they signed their new contract in 2008 they agreed to pay any private fees in excess of their quota to a research fund in the hospital where they are employed.

"To date there have been no payments to the research and development fund. This is outstanding," a HSE spokesperson confirmed.

"Consultants are requested to provide 20pc of the money owing as an initial step. To date, no consultant has remitted any money."

Doctors' organisations have previously resisted any attempt to extract any money from the consultants saying the method of calculating the public-private ratio of patients is flawed.

The cash-strapped HSE can no longer be seen to tolerate the resistance after already taking on other so-called vested interest groups -- cutting the income of GPs, pharmacists and dentists.


Doctors were initially given nine months to reduce the quota of private patients they treat. But in many cases they were still not in line after 18 months.

The individual consultants who have not paid back any money by the September deadline are threatened with having their right to private practice removed. It means they could continue to treat existing private patients who are in their care, but they cannot take any payment for the work.

"Failure to comply with the request to remit funds will result in an instruction to cease charging private patients," said the HSE spokeswoman.

The HSE spokeswoman said it had "encountered significant non-cooperation from consultants with any attempt to limit private practice in line with the 2008 contract".

However, she said the HSE was hopeful the matter would be resolved and that given the time -- less than three weeks to the September 15 deadline -- the doctors would pay the money.

Martin Varley, secretary general of the Irish Hospital Consultants Association said yesterday his organisation would be advising individual consultants on their public-private ratio to ensure it was measured correctly.

The figure of 20pc set for the initial penalty has been set pending clarification of the tax status of the doctors' private fees. But this sum is set to rise, leaving consultants liable for hefty payments to their hospitals in the future.

Hospitals where doctors have breached their quota include Limerick Regional Hospital; Galway University Hospital; St Luke's Hospital in Kilkenny; Beaumont Hospital in Dublin; Our Lady of Lourdes Hospital in Drogheda; and Mayo General Hospital.

Irish Independent

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