LOCAL MANAGEMENT in the Health Service Executive (HSE) has begun the process of holding meetings with consultants whose private practice levels are significantly above permitted levels.
Senior HSE sources said last night that if there were no anomalies in the calculations of private practice rates, it would begin the process of taking steps outlined in the new consultant contract for dealing with such circumstances. This could include consultants’ fees from private practice over and above official limits being directed to a research fund in the hospital concerned.
Senior HSE sources said it would address the issue of compliance with private practice levels in a descending order with the most extreme cases being dealt with first. The sources said the HSE would be working with the Irish Hospital Consultants Association (IHCA) on fine-tuning the methodology for calculating private practice rates.
IHCA assistant general secretary Donal Duffy yesterday said that figures suggesting that more than 200 consultants had seen too many private patients in public hospitals were not a true and accurate measure of their activity.
He said the HSE figures, which showed 218 consultants had been warned they were in breach of their contracts, were totally distorted. The extent of the warnings was contained in a HSE report released to The Irish Times under the Freedom of Information Act.
Last night Eric Young, of the Irish Medical Organisation, said the system for measuring the work of consultants resulted in many inaccuracies and that it was “hard to have confidence in it”.
Mr Young said that in many instances consultants with public- only contracts often had little control over the patients they saw in an emergency room setting and this often posed problems.
Mr Duffy said the work carried out by consultants in emergency departments was not logged in the public/private measurement system.
“We have significant difficulties with the system the HSE has put in place because it is not a true and accurate measure of what consultant activity is and therefore the results that are produced are also inaccurate,” he told the Today with Pat Kenny show on RTÉ radio.
As well as not including the emergency work, Mr Duffy said some consultants who had public-only contracts had consultations with private patients at the request of colleagues and that these were often counted as private work.
The chairman of the Dáil Public Accounts Committee, Bernard Allen of Fine Gael, said it was difficult to gauge value for money and to ascertain what was going on in hospitals as a breakdown of consultants’ work could not be obtained.
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About one quarter of all those discharged from inpatient treatment in public hospitals in 2008 were private patients, according to a new report drawn up by the Economic and Social Research Institute. The report also stated that for those admitted to hospital, the average length of stay for public patients was slightly longer at 6.4 days compared with 5.6 days recorded for private patients.