Patient care: The president of the Irish Medical Organisation (IMO) has expressed "serious clinical concerns" about the operation of the National Treatment Purchase Fund (NTPF).
Responding to NTPF chief executive Pat O'Byrne's claim two weeks ago that some consultants were not referring as many patients as they could to the fund, IMO president Dr Christine O'Malley said, "there are serious concerns that the NTPF may be pushing people who are not suitable for the scheme into private hospitals".
"The reality is they [ the NTPF] are running out of patients who are suitable for treatment in private hospitals, which are stable, elective patients who can travel and only have single problems," she said.
Dr O'Malley said the NTPF, in trying to get more patients, is going into the "next layer of patients who are elective but are not as stable or have other illnesses".
She said she had heard of a patient treated in private hospital under the fund who had to be transferred to a public hospital because of post-operative haemorrhaging.
The NTPF was set up in 2002 to reduce the length of time public patients are on hospital waiting lists for three months or more by finding spare capacity in the public and private system.
Last year the NTPF arranged treatment for 18,197 patients, bringing to more than 43,000 the number of patients who have had their operations under the fund since July 2002.
Dr O'Malley also said the fund, which she claimed "separates the patient from the physician", had bypassed "usual clinical relationships that act as safeguards".
Normally patients were referred to the surgeon as outpatients, and the surgeon and patient discussed likely treatments, she said. The surgeon would offer to operate on the basis of the surgeon's own knowledge of the patient, their ability and the hospital where the procedure was going to take place, she said.
In late 2005 the Government decided that no more than 10 per cent of surgical operations paid for by NTPF should be carried out in the public hospital system. This is having an impact on training with surgeons not getting the chance to train in elective surgery because all planned work is being pushed over to private hospitals, she said.
An NTPF spokesman said it rejected the idea that unsuitable patients were being treated under the fund.
The NTPF was "concerned only with what is right for patients and does not differentiate according to the operation a patient is waiting for", the spokesman said.