Maternity care will be harmed if private beds lost, consultants warn
'Hospital incomes will fall with little gain in bed capacity'
Removing private care from public hospitals will not boost bed capacity and will have a serious impact on maternity services, consultants have warned.
An independent review group, led by Dr Donal de Buitléir, is examining the decoupling of private and public health services as part of the planned Sláintecare reform.
Health Minister Simon Harris has said he believes that to achieve an equitable health system, where people are not treated on their ability to pay, the two must be untangled.
There are concerns about the impact that pulling private practice will have on the public system. Private care is worth around €600m to public acute hospitals and a key question being examined is how this shortfall might be met if the two are separated.
In its submission to the expert group, the Royal College of Physicians of Ireland (RCPI) warned that it does not believe capacity would be boosted by taking private beds out.
Many patients categorised as private may be in public hospitals due to the complexity of their case, and removing them would mean they still needed to remain in a public hospital.
"This would lead to a significant loss of income with little matching gain in capacity for the public system," the submission states.
The Institute of Obstetricians and Gynaecologists has also warned the removal of private practice would have a specific impact on maternity services.
There are currently no private facilities where women can give birth and maternity hospitals derive substantial funding from private beds.
Removing it would also "deprive women of their choice" of care, it warned.
The RCPI is also concerned the separation of the two systems may worsen the recruitment and retention crisis in the HSE.
It said separation must be done in the overall context of Sláintecare, which proposes wholesale reform. Work is under way to examine the terms and conditions of HSE staff and 2,600 new beds are planned.
In their submission the Irish Nurses and Midwives Organisation (INMO) said it supported the disbanding of the two-tier system, describing it as "deeply flawed".
In order to fund the revamped system, the INMO has called for a hike in employer PRSI to generate funding which can be ring-fenced for health.
The INMO also called for the phased abolition of all tax relief on private health insurance and for an end to subventions to private nursing homes. It wants health professionals to be directly employed by the State.
Private health insurers have also raised concerns about the potential move.
Vhi warned it would close the company's cheaper non- advanced plan, which offers access to private treatment in public hospitals. Around 200,000 people would be forced on to a more costly plan.
In its submission, Laya Healthcare said it welcomed an opportunity to collaborate on the disentanglement, but warned it would not address the "systematic inefficiencies" that exist in public hospitals.
The company also raised concerns about continually rising premiums due to the increased cost and volume of claims, which it said will drive more people into the public health system and may lead to employers dropping health insurance schemes for employees.
Irish Life Health called for a change to the insurance levy - from a flat rate to a proportional rate - to make policies more attractive for the young and people on lower incomes.