THE HEALTH Service Executive (HSE) is to impose financial penalties on hospitals in which consultants are considered to be seeing too many private patients.
From January, hospitals will not receive additional funding in their budgets from the HSE to cover pay increases awarded under the revised 2008 contract in the cases of consultants for whom private patients account for more than 50 per cent of the total number treated.
From next April, this financial penalty will apply to hospitals where more than 40 per cent of those treated by a consultant are private patients.
The financial penalties planned by the HSE will apply to the funding provided to hospitals. It does not mean individual consultants will face pay cuts. Separate sanctions can apply to consultants for persistently breaching official private practice levels.
Highly placed sources said the aim of the new plans was to encourage hospital management to ensure compliance with the private practice limits set out in the revised consultant contract.
In a confidential memo to senior managers in the various HSE regions on Tuesday, the organisations national director for commercial services and reconfiguration, Brian Gilroy, said it was now clear there were still a number of consultants who were not in compliance with the terms of the public-private mix in their new contract.
This stipulates that the ratio of public to private patients treated by doctors in public hospitals should range between 70:30 and 80:20, depending on the type of contract held by each doctor.
Under the terms of the revised contract, some consultants were set to receive salary increases of between €50,000 and €60,000 in return for working over a longer day and at weekends, as well for co-operating with changed work practices.
However, not all of the increases were paid by the Government, and cuts of 15 per cent were applied last year.
The new HSE moves could result in budgets being squeezed in hospitals where there are considered to be clusters of consultants treating too many private patients.
In his memo to HSE regional directors, Mr Gilroy stated: “As we have approached the process in descending order of non-compliance, I now wish to inform you that your hospitals can no longer be funded beyond the 1st January 2011 for any of the consultants in the original 50 per cent group who are not now compliant and beyond 1st April 2011 for the group of consultants who are in the 40 per cent group.” He added: “The funding referred to above is the additional funding provided under the 2008 contract for those consultants.”
Last August the HSE signalled it planned to warn officially about 35 consultants in hospitals that they could face sanctions for treating excessive numbers of the fee-paying patients. However, the Irish Hospital Consultants’ Association is challenging the methodology used by the HSE in calculating the level of private practice. It has said the system adopted by management in the health service is “fundamentally flawed”.
Under the terms of the revised contract, consultants who are consistently in excess of the permitted private practice levels can be asked to contribute money earned above the official limits to a research fund in their hospital.