Governments plans to build private hospitals on the grounds of public hospitals in the Republic were strongly criticised by several keynote speakers at the annual meeting of the Irish Medical Organisation (IMO) yesterday.
James Sheehan, consultant orthopaedic surgeon and founder of the Blackrock and Galway clinics, described the plans announced last July by the Tánaiste and Minister for Health, Mary Harney, as a "total non- starter". Jim Power, chief economist with Friends First, told doctors there was a risk the Tánaiste's plans could create a "market failure" in the health system. And Dr Fergus O'Ferrall, director of the Adelaide Hospital Society, said the plans, which are aimed at freeing up 1,000 public beds, did not represent an "evidence-based" approach to health policy.
Speaking during a session titled "Public and private investment in healthcare: what will deliver for the patient?", Dr O'Ferrall said the evidence available from the most reputable international and national sources "does not support the proposal for private hospitals from the point of view of either the most effective use of our financial resources or securing the best health outcomes for our people.
"It appears to be based on a practical Irish solution to an Irish problem . . . I say 'appears' because we have had no coherent published rationale - no white paper and no debate in the Oireachtas - and no consultation with citizens, much less with the public hospitals concerned."
Quoting Canadian health services research, Dr O'Ferrall said private hospital costs were significantly higher than those in the public sector.
The research also suggested poorer outcomes for patients treated in the private sector, including higher death rates. Calling on the Government and the Health Service Executive (HSE) to publish the research behind the "for-profit" healthcare initiative, Dr O'Ferrall said: "The evidence that is available to us supports public 'not-for-profit' healthcare in regard to both cost and outcomes."
Accusing the Government of neglecting healthcare infrastructure in comparison to that of housing and transport, Mr Sheehan described a concept of "State lag" in healthcare, whereby a 20-year gap existed between identifying a health service need and meeting that need.
Based on his experience with the Galway Clinic, where the hospital made half its beds available to the National Treatment Purchase Fund (NTPF), only 7 per cent of which were taken up, Mr Sheehan said: "If the concept of a community hospital had worked well in Galway and been taken up elsewhere, we could have the finest health service in the world in three years."
Speaking from the floor, Dr Tony Healy, consultant anaesthetist at the Royal Victoria Eye and Ear Hospital in Dublin, said a number of NTPF patients with ear problems had attended the hospital's A&E department with post-operative problems following initial treatment in the UK.
Some patients returned with complete deafness having flown back within 48 hours of major ear surgery.
Mr Power told doctors that while there was a role for the private sector to complement the public health system, it was better to invest money directly in the health service than to give tax breaks to develop the system.
"A lot of ideas put forward by the Minister for Health in the last 12 months could create added problems for the health sector," he said. "There is a danger that complex cases will not be catered for in private hospitals and that talented healthcare professionals will drift to the private system and away from public health service,"