Rules limiting private practice in hospitals ‘a farce’ – HSE chief

The application of rules restricting the level of private practice senior doctors can carry out in public hospitals has become a "farce", the head of the HSE has told the Minister for Health.

In a confidential email to Leo Varadkar, HSE director general Tony O'Brien also said large voluntary teaching hospitals were in some instances "breaking the rules" in how they went about recruiting consultants.

A contract introduced in 2008 set limits of 20 per cent on the level of private patients that could be treated by most public hospital consultants.

However in his email Mr O’Brien said the percentage division between public and private was “a farce in practice”.

He blamed the introduction of new legislation in January 2014, which allowed hospitals to charge for all private patients. Previously, insurers paid only for those who occupied the 20 per cent of beds designated for fee-paying patients.

Winning the battle

Mr O’Brien’s comments came in reply to an email sent by Mr Varadkar last autumn in which he said he was not sure the health service was “winning the battle yet” in relation to the recruitment of consultants.

The Minister said some voluntary hospitals “are much better at recruiting (other than Beaumont) and I know that they are more flexible in their approach, perhaps sometimes bending the rules but getting a result”.

The acknowledgement by the head of the HSE of difficulties in policing private practice limits comes as the health service faces strong criticism over waiting lists and the numbers of patients on trolleys.

Official figures released last night show Mr Varadkar has failed to fulfil his promise to eliminate long waits for hospital appointments, despite spending over €50 million.

At the end of December, more than 10,000 patients had been waiting over 15 months for an appointment or procedure. Mr Varadkar had promised that, by this date, no patient would be on the list for this length of time.

The overall outpatient waiting list fell last month to 375,000, the lowest figure for the year, down less than 10 per cent from a peak of 414,000 in mid-2015.