Mary Harney (Dublin Mid West, Progressive Democrats)

I do not believe that there will, in fact, be a loss of €50 million to public hospitals arising from the new consultants' contract, and I will set out the reasons. A central objective of the new consultants' contract is to improve access for public patients to public hospital services. It ensures, for example, for the first time in public hospitals, that patients needing outpatient or ambulatory diagnostic care will be seen on the basis of medical need, with no distinction between public and private status.

Consultants holding the public-only, type A contract do not undertake any private work and no patient admitted under the care of such a consultant can be accorded private status. Public hospitals may not, therefore, impose a private accommodation charge where a patient is admitted under the care of a type A consultant, nor may another consultant involved in the treatment of such a patient charge a fee. Approximately 560 of 1,550 consultants who have accepted the new contract have this type A contract.

Public hospitals earn income from health insurance companies for private patients admitted only to designated private beds. The only way that the HSE could be at a loss of €50 million, as a result of the new consultants' contract, would be if designated private beds in public hospitals went unoccupied by private patients for a significant part of the year. I do not expect that to happen, because approximately 1,400 consultants will still be in a position to treat private patients in public hospitals. It can be expected that the 980 consultants on the new contract who are allowed private practice, plus the approximately 400 consultants remaining on the old contract, will continue to admit and treat sufficient numbers of patients, so that there will be little, if any, loss of private bed income to the hospitals concerned. Thus, in practical terms, I do not expect a €50 million loss, or any material loss, to public hospitals as a result of the new contract.

See this speech in context