New HSE chair in favour of removing private practice from public hospitals
Plans to remove private practice by consultants from public hospitals were supported yesterday by the new HSE chairman, Ciarán Devane.
Mr Devane, who is heading the HSE board with a strengthened set of powers, said the removal of private practice from public hospitals is clearly set out in the Sláintecare plan for the future overhaul of the health service.
The HSE is a public service and it is necessary to examine if the use of private providers creates "perverse incentives", he added.
"Is an operating theatre being competed for in a particular institution... I would be starting with the outcome and say 'are we restricting access to the public service which the taxpayer is paying for by some of the things we do?'" he told the Oireachtas Health Committee.
The move will potentially set the HSE on a collision course with consultants, who stand to lose income and be confined to fee-paying patients in private hospitals.
The department is currently considering a report on the proposal and is expected to take the first steps in the process in the autumn.
Questioned by Fianna Fáil TD Stephen Donnelly on the extent of the board's power to sanction or remove under-performing managers, he confirmed it could act if it was felt the health of the population was being put at risk.
It will be important to have the right processes in place to ensure a manager is clear on what they are accountable for, he said.
Asked by Mr Donnelly on how he plans to tackle waiting lists - some of which are worse than in parts of Africa -Mr Devane said he agreed that access was a problem.
There is a need to improve staffing and models of care to bring improvements, he said.
He reiterated the need for the HSE to live within its budget and not to spend "money it does not have".
It is the only way it can make a case to the Government when it asks for more or specific funding. "We want the credibility of saying that 'you gave us money. We spent the money brilliantly'," he said.
"What we cannot do is surprise the Government and say 'we went off and spent anyway'. It is about having a financial grip," said the Dubliner, who is based in the UK.
Earlier this week, it emerged that the new director general of the HSE, Paul Reid, was warned by senior managers that there was a "challenge between safety and cost constraint" and that staffing levels were "too low for safe care in some areas".
Mr Devane said it would be important for the HSE to demonstrate that it had learned from mistakes which have involved patients.
"Get things wrong and people will forgive you, if you learn the lessons," he added.