Monday 24 June 2019

Consultants 'paid on the double' to clear waiting lists

Additional €50m funding allows some patients to be operated on at weekends

Minister for Health Simon Harris. Photo: Gareth Chaney, Collins
Minister for Health Simon Harris. Photo: Gareth Chaney, Collins
Eilish O'Regan

Eilish O'Regan

Some hospital consultants are to be offered top-up fees to treat their own patients under the Government's €50m plan to clear waiting lists, it has been confirmed.

A consultant, who is on a salary of more than €100,000, would effectively be paid on the double for treating the patient.

Some patients who are on the consultant's waiting list and cannot be treated during normal hours because of hospital pressures will be operated on at weekends for additional funding.

The initiative, which involves buying treatments for waiting list patients in private and public hospitals, is a desperate attempt to reduce the massive queues for surgery.

More than 20,000 of the 80,000 public patients who need surgery will have procedures such as removal of cataracts, lesions or hip operations paid for out of the special €50m allocation.

A number of public hospitals with spare theatre space will tender to treat 4,000 of these patients in return for a fee.

This fee, which will be paid to the hospital, covers the outlay of paying staff, including consultants, for the extra work as well as meeting other costs.

Payments are made to the public hospital by the National Treatment Purchase Fund (NTPF), which has been given the €50m to pay for the procedures.

It was learned yesterday that some consultants will be allowed to treat patients from their own lists under the initiative.

However, a spokeswoman for the NTPF said that it would only happen in "exceptional" cases. He said: "This would only arise having regard to the interests of the patient, good governance and value for money."

He stressed that there were circumstances where "there are a limited number of specialists available to provide treatment in the locality".

"Public hospitals may submit proposals to the NTPF to carry out additional treatments.

"Such proposals are considered and accepted if suitable in the interests of patients, good governance and value for money," he added.

"Where the fund sources treatment in public hospitals it does so on the basis it is taking advantage of available resources."

The NTPF pays the public hospital a fixed price per procedure performed.

Health Minister Simon Harris has said that the Eye and Ear Hospital in Dublin, Nenagh General Hospital and Roscommon Hospital are among the public hospitals which will get extra funding to do waiting list work.

The plans so far only cover surgical lists and there has been no indication of how much will go towards buying specialist appointments for more than 500,000 patients on outpatient waiting lists.

The bulk of the €50m will go towards private hospitals.

A lack of beds and doctors are contributing to the failure to meet the needs of public patients on waiting lists and figures have reached a record high.

The trolley crisis means patients on waiting lists can have their planned surgery cancelled at short notice.

The action plan for inpatient and day case surgery says that treatment will be offered to all patients who are currently waiting for more than nine months in high volume specialties such as cataracts, hip and knee replacements, tonsils and scopes.

Overall, the plan is to carry out 1.14 million elective procedures during the year.

Figures for March show 4,318 of those on waiting lists for surgery were children, of whom 481 were in the queue for more than 18 months.

Speaking in the Dáil, the minister said he wanted to remove private practice from public hospitals and would have an expert report at the end of the year.

"I accept it is a good idea," he added.

He said the expert group report chaired by Donal de Buitleir is not to tell him whether it is a good or a bad idea.

"I want to make clear the purpose of the report is to show me the roadmap on how to do it," he added.

This would free up public hospitals for the care of public patients.

Irish Independent

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