Hospitals will face a €700 million hole in their budgets if any attempt is made to deprive them of income from private patients, Minister for Health Simon Harris has warned.
There were sharp exchanges at the meeting of the Oireachtas Committee on the Future of Healthcare as Mr Harris took issue with Opposition TDs over the future role of private medicine in the health system.
The Minister accused some members of the committee of misrepresenting his views to pursue “ideological warfare” after he outlined his vision for the future of the system for the next 10 years.
This includes the dismantling of the HSE in favour of regional health bodies and a “slimmed down” national body responsible for services such as cancer programmes and the Fair Deal nursing home scheme.
In a wide-ranging presentation, the Minister acknowledged the interweaving of public and private services in health is one of the most controversial aspects of the system.
But he also stressed the advantages of the public-private system in ensuring the recruitment of high-calibre staff and providing additional income from public hospitals.
Concerns about access to health services could be addressed by the introduction of stronger incentives for hospitals and consultants to treat public patients, he suggested.
Under his proposal, consultants treating private patients would move away from the current fee-for-service payments to an annual remuneration for both their public workload and their permitted level of private activity.
Sinn Féin health spokeswoman Louise O'Reilly claimed the Government and the Department of Health were "busy undermining" the potential of the committee to succeed in its work.
While the committee was focused on providing universal access to health services, they wanted to continue with the status quo and with private medicine.
Solidarity/PBP TD Mick Barry called for the nationalisation of private medicine and also of voluntary hospitals and agencies (so-called Section 38 and 39 bodies).
The desire for a stronger public health system was not compatible with a situation where the other three branches of the system were not fully owned by the State, he said.
“The private sector has a vested interest in doing down the public health sector; for it to succeed, public health must fail.” Many Section 38 and 39 bodies, which are largely funded by the State, could not survive for a week without public backing, he said.
Mr Harris said there was an overwhelming consensus in favour of the provision of universal healthcare based on medical need but differing views as to how this goal might be reached.
Referring to the preference of many committee members for a system similar to Britain's National Health Service, the Minister said the NHS was "far from perfect".
Mr Harris also told the committee existing hospital groups and community healthcare organisations (CHOs), which are responsible for social services, need to be “geographically aligned” and put on a statutory basis.
Pending the dismantling of the HSE, legislation is needed to reform the organisation to improve governance.
Initiatives such as the cancer programme, integrated care programmes, the Fair Deal nursing home scheme and e-health should remain in a “slimmed down” national body while other functions are devolved to the regions.
Eligibility for primary care services should be expanded “on a phased and prioritised basis” over the next 10 years.
