Study will guide Harris over ban of private patients in public hospitals

The Minister for Health will be guided by a forthcoming impact analysis on whether private practice should be eliminated in public hospitals.

The Government’s new Sláintecare blueprint for reforming the health system calls for a ban on the treatment of fee-paying patients in public hospitals.

However the proposals have been strongly condemned by the Irish Hospital Consultants Association (IHCA) which claimed they would result in hospitals being impoverished and lead to a mass exodus of senior doctors.

Simon Harris said both he and Taoiseach Leo Varadkar had previously said they would like to see the de-coupling of private practice from public hospitals. He was speaking at the IHCA annual conference in Limerick on Saturday.

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“I find it very difficult to stand over a scenario where you could have a public patient waiting in a very packed emergency department and yet private practice continuing in that public hospital in an unquestioned manner.”

However he said it was important to acknowledge the huge contribution that private patient income was making to the public hospital system. He said this generated between €600 million and €700 million annually.

“That is why the Sláintecare report sensibly calls for an impact study to be done.”

“I would appeal to the IHCA and everybody else in the healthcare system not to give a knee-jerk reaction to this. There will be an impact study. Let us look at the facts . But reform does mean people changing and we can’t just be in favour of reform when it means other people changing. We are all going to need to change in relation to the way we work to deliver a better health service.”

“Let us look at the analysis (from the impact study). That is what Sláintecare says. People would be rightly criticising me if I was not moving ahead with the first cross-party political plan for healthcare.”

“But I will be guided by the outcome of the Impact report because that is what Sláintecare asks me to do.”

Decoupling

In his address to the conference Mr Harris said that “decoupling private from public practice is far from simple but it certainly is worth considering”.

He said people working in and requiring access to the health service had been sick and tired of previous reform process stopping and starting as political cycles changed.

He said the Sláintecare reforms enjoyed support from across the spectrum and “I do not think we should waste the opportunity that is provided by political consensus.

Mr Harris said there needed to be greater alignment between hospital groups and community healthcare organisations.

“The idea that while we talk about integrated healthcare but we have one management structure for the acute hospitals and completely separate and distinct one for community health just simply is not sustainable. The current silos cannot continue.”

The Minister also told the conference that he was open to the idea of establishing hospital facilities for elective or non-urgent patients only.

"We have seen in neighbouring jurisdictions, like Scotland, where they have produced elective-only hospitals, that waiting lists have dramatically reduced and waiting times have dramatically reduced. "

Mr Harris said he needed the support of doctors for the new public health alcohol legislation to “ debunk the myths and the nonsense” being put forward by the well-heeled drinks industry.

Alcohol

“We have a situation that three people per day die in this country of alcohol-related diseases and the best the drinks industry can come up with is suggesting that I am trying to cancel Christmas by shelving the Guinness ad.”

He was referring to a claim last month by industry body, the Alcohol Beverage Feration of Ireland that the advertising restrictions in the Public Health Alcohol Bill would result in most of the Guinness Christmas ad being unusable.

"Are we actually going to get serious by addressing the elephant in the room here. We have a problem with alcohol in this country and never, never in the history of our State has the Oireachtas bothered to pass a piece of legislation in relation to alcohol from a public health point of view."

“Will our politicians, backed by our clinicians, be willing to stand up to the drinks industry in the interest of the next generation of our citizens?” he said.

Waiting lists

Mr Harris also said that the number of people on waiting lists for treatment was “totally unacceptable”. However he said there had been progress in recent months where the number of people actually waiting for a hospital operation had declined by 3,000 and there had also been the first decline in the numbers queuing for an out-patient appointment in many years.

“We are going to do an awful lot more and the Budget 2018 will be delivering additional resources to drive down waiting lists.”

“One- in- three of our patients still get to hospital for a procedure or appointment within three months, more than half within six months. Yes there are too many waiting a long time but it is simply not the case that everyone is waiting a long time.”