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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
(27 Jun 2019)

Peter Burke: He hopes to make a decision before the summer break.

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
(27 Jun 2019)

Peter Burke: I am sure the Department is very cognisant that some of the hospitals have significant clinical links built up with teaching hospitals based on the existing groups. A huge amount of energy and work has gone into making the services what they are in some of these hospitals. There is a fear in some that they may be aligned to different groups irrespective of the CHO area but they have...

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
(27 Jun 2019)

Peter Burke: With regard to the report of the Comptroller and Auditor General on the control of private patient activity in acute public hospitals, the consultants' contracts have a variation of between 0% and 30% with regard to the maximum workload in the private sector. Why do we have this variation? Why would one consultant's contract allow 0% private work while another may allow 30%? What is the...

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
(27 Jun 2019)

Peter Burke: If a consultant sees outpatients in a public hospital who do not require a bed, such as a consultant offering maternity services to a lady with private health insurance who attends an appointment in a public hospital, how are these structures monitored? How does the HSE adjudicate the level of time and the number of private patients and compare it with the number of public patients to ensure...

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
(27 Jun 2019)

Peter Burke: Is it counted at all?

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
(27 Jun 2019)

Peter Burke: Even numbers-wise, is it counted? Obviously, it is not rocket science to find out the numbers and the average fee that a consultant will be charging for the services.

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
(27 Jun 2019)

Peter Burke: Which is significant.

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
(27 Jun 2019)

Peter Burke: To focus on the previous group, for example, how does the HSE monitor it? How does it know the level of activity it is running at?

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
(27 Jun 2019)

Peter Burke: In that case, it is not really working at all.

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
(27 Jun 2019)

Peter Burke: That is a very significant issue and it is not acceptable that it is not being managed properly.

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
(27 Jun 2019)

Peter Burke: It is even more criminal in one way when they are seeing patients in the public hospital, utilising that space, and the HSE cannot get a handle on it.

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
(27 Jun 2019)

Peter Burke: Why is it difficult? This is what I do not understand.

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
(27 Jun 2019)

Peter Burke: Let us go back to a more simple thing.

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
(27 Jun 2019)

Peter Burke: Let us refer to someone going for maternity services. Forget about disease and seriousness of case. Let us say people are going in for routine examinations, some of whom are private and some of whom are public patients. I would have thought that would be very straightforward to distinguish. Any control system worth its salt should be able to differentiate between them.

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
(27 Jun 2019)

Peter Burke: There "may well be" a facility but there is not one.

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
(27 Jun 2019)

Peter Burke: If one were to look at the tax return of an average consultant based on the 0% to 30% rule for private practice, one would see scheduled employment income from the HSE and also private income. We have heard from the Revenue Commissioners and other bodies in both the finance committee and at this committee about Revenue operations to clamp down on practices put in place by consultants in...

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
(27 Jun 2019)

Peter Burke: In general.

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
(27 Jun 2019)

Peter Burke: I know there can be reasons for things, but that tells one something is not right in the system when it is exceptionally off. It is unacceptable that the State and the HSE do not have a handle on fee income from private patients coming into a public hospital and using public facilities.

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
(27 Jun 2019)

Peter Burke: Does Mr. Breslin think it is unacceptable?

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
(27 Jun 2019)

Peter Burke: I can see that some areas are complex but it is the simple ones that do not seem to be managed.

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