Clampdown sought on doctors' A&E charges

The Department of Health has asked the Health Service Executive (HSE) to clamp down on doctors charging private fees to patients attending A&E departments in public hospitals.

In a letter sent to the HSE earlier this month, the Department of Health said that it had recently come to its attention that an elderly woman who was treated at the A&E department in one of the main Dublin academic teaching hospitals had later received a bill for private service from a consultant who attended her.

The Department said that the woman paid the bill but when the matter was subsequently queried by her family the money was repaid.

The Department said that the woman wished to preserve her anonymity and that it was not at liberty to reveal her name or the identity of the hospital.

"I am sure you will agree that it is outrageous that anyone, least of all an older person, should be subjected to behaviour of this kind. I cannot say whether this practice is widespread but I find it hard to believe that this is a once-off incident," a senior Department of Health official wrote in the letter to the Director of the National Hospital Office of the HSE, John O'Brien.

The Department asked the HSE to "take whatever steps are appropriate to ensure that all hospitals are reminded that no private fees are payable by patients attending A&E departments in public hospitals".

However, the Irish Medical Organisation (IMO) has strongly criticised the Department of Health instruction on private fees in A&E departments which was passed on by HSE management to hospitals over the last week or so. In a letter sent to Michael Scanlan, secretary general of the Department of Health, the IMO said that consultants in emergency medicine were contractually entitled to engage in private practice.

The IMO said that the Department of Health letter had also ignored the fact that patients who attended emergency departments and were subsequently admitted to associated observation wards/clinical decision units under the care of consultants in emergency medicine could choose to be treated on a private basis and in such cases the treating doctor was entitled to payment.

"Consultants in emergency medicine are employed on the basis that they can engage in private practice while receiving a salary pitched at a level which assumes they exercise this right; it is therefore doubly punitive to deny such consultants the right to exercise their full contractual rights while also abating their salary, as is the case in a number of areas of the country," the IMO stated.

The IMO said that it was long past time that consultants in emergency medicine were properly compensated for their loss and persistent attempts to undermine their contractual rights.

It said that the private practice rights of A&E consultants was on the agenda for the current talks on a new contract for hospital consultants.

The IMO said that in advance of any resolution of this substantive matter, the Department of Health should desist from inflaming this situation further.

It requested that appropriate steps be taken to have the HSE circulars to hospitals withdrawn.