Mr. Tony O'Brien:

Senator Crown raised the issue of differential contracting between conventional private suppliers and the section 38 hospitals. The contract documentation is very different and the relationship is different. St. Vincent's University Hospital is regarded as a public sector employer, as per section 38. In common with other instances that have emerged through the section 38 audit, we have uncovered a number of hornets' nests around the place. These have been aired here and at another committee. The current issue with St. Vincent's University Hospital is one of trust and transparency. At a point in time we were advised in writing that only a handful of public consultants - that is, those without rights to practice off-site - were working in St. Vincent's private facility and that this only occurred in rare and exceptional instances of critical patient care need. Obviously, one would have to accept that such instances could arise. However, what has emerged in correspondence within the last month is a very different story, with dozens of consultants routinely practising in the private hospital and a series of legal arguments advanced in support of that. Our position is very clear. Whatever pretext or grounds have been developed, consultants have been appointed through an approvals process on the basis that they would be public consultants. It now appears that the St. Vincent's Group is seeking, effectively, to operate its private hospital substantially on the back of that provision, where the primary employment is a public employment funded by the tax payer. We will not do anything to jeopardise ongoing patient care, but this does fundamentally impact on our future relationship with that hospital if this situation pertains. We certainly could not see our way to sanctioning further investments in that hospital.

As Senator Crown correctly identifies, one cannot just be pulling the plug from hospitals that are contributing very significantly to the totality of our health care environment, but we need to return to a position where we are no longer operating on the basis of trust because trust, once given and not reciprocated, tends to disappear very fast. We need absolute transparency. There is a new interim chief executive officer of the public hospital. We will shortly be seeking to meet him and the chairman of the group to establish a fresh basis for our future relationship.