Wednesday 18 September 2019

Consultants 'need to give up €140m a year of private fees'

Optimistic: Dr Donal de Buitléir with a copy of his report at the launch in Dublin. Photo: Frank McGrath
Optimistic: Dr Donal de Buitléir with a copy of his report at the launch in Dublin. Photo: Frank McGrath
Eilish O'Regan

Eilish O'Regan

More than 2,500 hospital consultants share €140m a year in private fees, but a new report has called for them to be paid to abandon this income and treat only public patients for a fixed salary.

The report said the consultants who leave their lucrative top-up private income behind would then be paid a salary which at current rates is up to €213,274.

Tempting consultants to renounce private practice is among the major hurdles outlined in the report by an expert group led by Donal de Buitléir.

Private health insurance premiums could fall in the short term - but they may also rise by a third.

People would also be asked to pay higher taxes to fund the annual shortfall of more than €500m to public hospitals due to the loss of private income.

The expert group was commissioned to examine the recommendation in Sláintecare, the cross-party blueprint for the health service, to remove private practice from public hospitals.

The State-funded hospitals would only treat patients on a public basis in a bid to reduce waiting times for surgery, outpatient care and diagnostics.

The extent of the compensation payment to consultants who would make the switch has not been calculated but the total bill would be likely to run into hundreds of millions.

Dr de Buitléir, whose report has yet to go to Cabinet, said yesterday he was an optimist and believes the removal of private medicine from public hospital could be phased over a decade.

The current two-tier system is "unfair and it is difficult to think of any other public service where people are treated more favourably simply because they can pay more for the service", he said.

It is equivalent to a parent paying a schoolteacher to give a child extra tuition, he added.

He said the HSE was unable to prove hospital consultants were not treating an excess of private patients.

The report said all newly recruited consultants should only be offered contracts that confine their practice to public patients.

The pay gap of around €50,000 between newly hired consultants and longer-serving colleagues should also be addressed, the report said.

It envisages a potential exodus of 800,000 people from private health insurance as more opt to be public patients.

But insurers would be left with mostly older subscribers who could see a premium rise of between 1pc and 7pc or one-third in a worst-case scenario.

The report acknowledges the problems in recruiting consultants but said better pay and conditions would make the jobs here more attractive.

Dr de Buitléir said the roll-out should not present a "shock to the system". The annual cost after 10 years would be around €650m after full removal.

Around €12m would be needed to pay extra consultants and €40m to meet the cost of treating more patients in the public system.

Health Minister Simon Harris said he welcomed the report, but said the switch would take time and cost money.

"I intend to consult with key stakeholders and my colleagues to consider implementation issues and return to Government in due course."

The report received a lukewarm response from the Irish Medical Organisation (IMO)and the Irish Hospital Consultants Association (IHCA)

The IMO said there is no evidence that capacity will improve or that waiting lists will be alleviated.

The IHCA said it has no confidence the loss of private health insurance income to public hospitals will be replaced by the Exchequer.

It was welcomed by the Private Hospitals Association and called on Mr Harris for a clear timeline of reform.

Irish Independent

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