Consultants’ dispute deepens as St Vincent’s misses deadline

The St Vincent's Healthcare Group has said it disagrees with the HSE over whether consultants paid by the exchequer and employed in its public hospitals can also work in its private hospital.

The group did not provide assurances sought by the HSE by yesterday that it would engage in a process aimed at ending this practice.

The HSE had warned that the group could face significant financial sanctions if it did not comply with its request.

In a letter to the HSE, the chairman of the St Vincent's Healthcare Group, Prof Noel Whelan, said the board disagreed with its interpretation of the 2008 consultants' contract based on the opinion of its legal advisors and the discussions of a task force convened a number of years ago involving both the hospital and health service management.

“Given the seriousness of this issue, not least for patient care, the Board is now seeking immediate legal advice on what action should be taken and will revert to you on the matter as soon as possible.”

The dispute between the HSE and the St Vincent’s healthcare group centres on whether consultants employed in the public hospitals on a particular contract known as type B can engage in practice in the group’s private facility. Since 2008, new hospital consultants have been appointed under either a category A contract, which allows them to work only in public hospitals, or on a type B contract, which permits limited private practice in public hospitals. However, the St Vincent’s Healthcare Group told the HSE earlier this month that its legal advice was that, as its private hospital was co-located with the public facility and operated by the same employer, its category B consultants could work in both institutions on its campus.

HSE director general Tony O'Brien said today (MON) that it had been misled by the St Vincent's Healthcare Group and warned that if the situation over consultants' private practice was not resolved, future State investment could be in jeopardy.

Any cut to capital or development funding would not necessarily affect patient care at St Vincent’s in the immediate term.

“One of the very specific concerns we have is that in the not too distant past it was implied in correspondence to the HSE that there were only ever a handful of public consultants who in very rare and exceptional circumstances of patient need were working in the private hospital. Its transpired in recent weeks that there are many dozens of consultants who are routinely engaged in such work. So we’ve had an issue of trust here first of all. Were we misled or were we not misled? We feel perhaps we were.”

Speaking to Seán O’Rourke on RTE Radio he said: “So we are asking the hospital to be absolutely transparent with us, and we are saying to the hospital very clearly that when it comes to the very difficult choices that we have to make about where resources go, capital resources, revenue resources, where we should support the development of specialities, when we are looking at reconfiguration of services. We will clearly have to make choices that are influenced to some extent by the level of trust that exists between us and individual hospitals.”

Mr O’Brien said it had now transpired that despite written assurances to the contrary which were received in the not too distance past, “there is a private hospital which is effectively being run on the back of the public hospital, through consultants who’s salaries are paid by the taxpayer”.

The Irish Times already reported that if there was no satisfactory resolution to the row, the HSE was planning to cut all capital or development funding to St Vincent's and St Michael's hospitals in south Dublin as well as to suspend their rights to appoint new consultants and refuse to sanction further lines of credit.