Dr. Gabrielle Colleran:

The patient profile is totally different as between public and private hospitals, such that one is not at all comparing like with like. Public hospital emergency departments must be sufficiently staffed and have the capacity to treat any emergency case that presents. Such cases would include a person who has had a stroke or brain haemorrhage or is presenting acutely with a tumour, as well as people involved in a serious road traffic accident who might need to see a vascular surgeon, neurosurgeon and orthopaedic surgeon. All of those specialists must be there to provide care in the middle of night, with access to anaesthetic services and an intensive care unit. Within the private sector, on the other hand, hospitals can cherry-pick the types of care they provide. To illustrate, I will use the example of a private MRI scanner. A private hospital providing a musculoskeletal MRI service might have 20 young men with sore knees in and out at a cost of €200 each. In Holles Street, on the other hand, we have very sick and intubated premature infants coming down for MRI scans, accompanied by senior nurses and neonatologists, with each such infant possibly spending an hour and a half in the scanner. If we compare our scanner with the scanner in the private hospital, the latter will seem to be much more productive because it was used for the young lads who were able to hop on and off in quick succession.

In fact, we are providing complex, high-level care and, as such, we will always be more expensive. However, if one is pregnant, if one is a child, if one is in a road traffic accident, if one has a stroke or a brain tumour, one will not be going to a private hospital but to one of our public hospitals. We need to be adequately staffed and have the infrastructure to provide that care. When one needs an intensive care bed in a public hospital, one does not join a waiting list.