The Rotunda maternity hospital has been warned it could have its funding pulled if it does not withdraw permission for consultants on public-only contracts to practise privately on its premises.
The HSE has told the State’s busiest maternity hospital, located on Parnell Square, Dublin, that any permission given to public-only consultants without its consent is “void” and must be withdrawn.
It has threatened to start a process that could result in funding being withheld or withdrawn from the voluntary hospital if the issues around private care were not resolved.
Minister for Health Jennifer Carroll MacNeill said the “very last thing” she wanted was to be in a conversation about funding cuts, but said Government policy on the matter was clear.
READ MORE
The issue came to light last week when Prof Seán Daly, master of the Rotunda, told the Oireachtas health committee how the hospital was allowing public-only consultants to continue to treat patients on a private basis.
[ Rotunda at loggerheads with Minister over public-only consultants having private patients ]
The HSE wrote to Daly on Friday, warning there was “not a shred of doubt” that the hospital should have known it did not have the power to give consultants on the public-only contract permission to carry out private work there. The HSE said it would have had to sign off on any such permission and said the Rotunda granting or continuing to give permission to consultants would be a “manifest breach” of its service level agreement.
Daly was told that his comments at the Oireachtas committee had given rise “to the most serious apprehension” in the HSE that the Rotunda was failing to comply with “exceptionally important” parts of its agreement with the health service.
The HSE said it was now considering “all its options”, including triggering a “performance issues” clause under its agreement with the Rotunda, which could eventually result in the health service withholding or reducing its funding.
The Rotunda has been given until June 8th to give the HSE a list of public-only consultants carrying out private work in the hospital.
[ Rotunda’s defiance of public policy shows us how some are born more equal ]
It must also report who granted this permission and why, the number of babies delivered by each consultant this year, the number of expecting mothers under the private care of these consultants at present and the amount of money billed for and received by the Rotunda for such services so far this year.
The correspondence between the HSE and Rotunda was shared with health committee chair Pádraig Rice, who is a Social Democrats TD. He said “the Rotunda, or any other hospital, cannot take it upon itself to unpick the public-only consultant contract”.
Daly wrote to the HSE last week to argue that the maternity hospital had the right to give consultants such permission. He said “to state otherwise is simply incorrect both as a matter of fact and law”. He said the Rotunda had sought the advice of law firm Arthur Cox on the matter.
Carroll MacNeill said the Rotunda was overwhelmingly publicly funded, but did also receive private funds. She said she did not want any consultants to be in the Rotunda only to treat women privately.
“I want those consultants who have been trained by the State, in the State, who are being paid by the State to work for all of the women in the Irish State who have risky pregnancies, to be there – and not just happen to be there because a woman with the opportunity to go private happens to be there,” she said.
A Rotunda spokesman said it had received a request from the HSE for further information and said the hospital was “currently working to provide this information within the stipulated one-week time frame, for further discussion with the HSE”.
Rice said he believes the Minister for Health is correct to talk about funding cuts for the hospital as the issue around public-only consultants continuing to provide private care was “quite serious.”
“I think the Minister is right. This is a serious breach of the contract of the landmark reforms to deliver universal healthcare under Sláintecare,” Rice told RTÉ Radio 1’s Today with David McCullagh.
“Individual hospitals, the Rotunda or any other, can’t be allowed to get away with going against State policy and agreed cross-party policy in the Oireachtas on Sláintecare. We can’t have individuals undoing that work,” the Social Democrat TD for Cork South Central said.
Rice said the public-only contract agreement should be enforced and consultants at the Rotunda “should do their public-only work in what are publicly funded hospitals.
“So that is the issue, it’s those who’ve signed the contract, and are now trying to get around that, and have the best of both worlds. They want the public-only contract, the good salary that comes with it, and they also want to continue their private work, and I don’t think that’s acceptable.
“We can’t have individual hospitals making these decisions that they’re going to just violate and breach contracts, that were long negotiated, hard fought for, and I think it’s important that people know, these consultants are being very well paid to do public-only work, in our public hospitals, that are funded by all of us to our taxes, and they should do that work, and they should deliver that quality of care to the women of Ireland, and I think that this is a really serious issue, and it’s welcome that action has been taken on foot of the interventions of the Health Committee last week.
Consultants were being well paid to give up private work and do public-only work in public hospitals, he said.
