Oireachtas Joint and Select Committees

Thursday, 27 June 2019

Public Accounts Committee

Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals

9:00 am

Mr. Jim Breslin:

It is historical. There is a series of contracts. If we go back, the 1997 contract might have variations whereby one person is not entitled to any private practice, in which case the private practice is 0%, while somebody else is entitled to private practice in public hospitals based on the percentage of beds designated as private in the hospital, which differs in various hospitals. We could have hospitals with percentages of 15% or 25%. Rolling forward, many people moved from the 1997 contract to the 2008 contract but at present there are still approximately 300 people working off the old 1997 contract. In the 2008 contract there are perhaps three or four variations. Again, there is a contract that is public only and consultants are not entitled to get private income; there is a contract under which people can do private practice but only in the hospital; and there is another contract that allows people to do private practice off site. All of these affect the actual monitoring of activity. Under the 2008 contract, if people are allowed to do private practice in a public hospital, it is at 20% of total activity, so for every four patients a consultant has, he or she can have one private patient and this is monitored. When a consultant is being assessed to see whether he or she is in breach we have to look at the contract to see what is the permitted amount.