Putting the public back in public hosptials
by Diarmaid Mac a Bhaird

Fórsa has welcomed proposals for legislation to ensure that public hospitals are used for public patients only. The recommendation is included in a report by the independent review group established to examine private activity in public hospitals, which was published earlier this week.


The report makes eight recommendations aimed at developing a single-tier public hospital system as envisaged in the 2017 Sláintecare reform programme, which has cross-party support.


They include the introduction of legislation to ensure that public hospitals are exclusively used for the treatment of public patients, and a new consultant contract that bars private practice in public hospitals.


The head of Fórsa’s health division, Éamonn Donnelly, said he welcomed the report’s recommendations, noting that they are in line with the union’s submission to the review body.


“Implementation of the independent review body’s recommendations would be a major step towards developing a fair and egalitarian health system,” he said.


But he warned that legal wrangles could stall the implementation of the report’s recommendations.


The independent review group estimates that it would take ten years to take private work out of public hospitals, and that it would take approximately €500 million worth of private health insurance payments out of the hospital system each year.


Recommendations of the Report of the Independent Review Group

• Introduce legislation to ensure that public hospitals are exclusively used for the treatment of public patients from the conclusion of the ten-year Sláintecare implementation period;
• All new consultant appointments should be to a Sláintecare Consultant Contract, which allows only public activity in public hospitals;
• Restore pay to pre-October 2012 pay levels for all existing Type A contracts and new entrant Sláintecare Consultant Contracts;
• Consultants holding 2008 (or earlier) contracts under which the consultant conducts private activity on a public hospital site should be offered a “contract change payment” to move to the new Sláintecare Consultant Contract;
• Introduce a scheme to allow a special derogation from pay caps to address recruitment to highly specialised posts;
• The Department of Health should ensure that HIQA’s quality and safety regulatory functions are extended to all healthcare settings;
• Comprehensive data should be collected on the nature and scale of activity in the private hospital system equivalent to those collected in the public system;
• Implement the agreed monitoring and reporting system to robustly monitor and enforce the existing consultant contract.

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