A DISPUTE between hospital consultants and the VHI means patients may face substantial additional bills from next week.
Balance billing will probably be introduced from next Tuesday.
The VHI sent out a new fees schedule yesterday without reaching agreement with consultants.
Up to 300 consultants are expected to reject the schedule which reduces fees, in some cases by up to 30 per cent, for procedures in their areas of expertise. Those patients affected will include cardiac, cancer, and ear, nose and throat.
The secretary general of the Irish Hospital Consultants' Association, Mr Finbarr Fitzpatrick, said yesterday it was regrettable that many patients would face the possibility of balanced billing for health care costs from April 1st "because of the failure of the VHI to complete negotiations on revised fee payments structures for 1997 and 1998".
"Our objective in these negotiations was to reach agreement with VHI and avoid the prospect of having to reintroduce balance billing which is not in the interests of our patients or the health care system generally," said Mr Fitzpatrick.
But the VHI argues that reforms are necessary in billing practices for consultants. Last year it paid hospital consultants £80 million, an increase of 18 per cent. Over the past six years, payments have increased by more than 125 per cent. VHI pays up to six hospital consultants £500,000 a year.
At present 94 per cent of consultants have a full cover agreement with the VHI. "If agreement is not reached about 30 per cent of consultants will not be fully participating," said Mr Fitzpatrick.
A VHI spokesman confirmed yesterday that the fees schedule had been sent out. The company had offered the IHCA several - possible dates for meetings. "The schedule was arrived at on the basis of the constant eagerness of the VHI to control costs," he said.
But Mr Fitzpatrick said the dates offered were towards the end of April and displayed no eagerness by VHI to settle the dispute.
Mr Fitzpatrick said they were now due to begin negotiations with BUPA. "We will now be contacting them to see if they would be interested in reaching agreement with consultants in these areas."
The IHCA, which has 1,000 members, said negotiations had not been concluded on the general fee increase being offered for two years. The VHI has offered 3 per cent for both years, which would be increased in the second year if inflation rose over 2.5 per cent. The IHCA, however, wants it increased to 4.5 per cent for 1998.