Written answers

Wednesday, 13 May 2020

Photo of Róisín ShortallRóisín Shortall (Dublin North West, Social Democrats)
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886. To ask the Minister for Health the cost basis for the agreement with the private hospital sector; and the way in which the figure of €115 million per month was arrived at. [5432/20]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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The Government published the National Action Plan in Response to Covid-19, on March 16. In anticipation of the projected surge in Covid-19 cases and the expected impact on the health care system a major part of the Action Plan was to urgently ramp up capacity for acute hospital care facilities. A critical element of the strategy was to put in place an arrangement with the private hospitals to use their facilities as part of the public system, to provide essential additional acute hospital services for the duration of the emergency. The terms of the arrangement reflected the expected Covid-19 pandemic at time of signing, and therefore is for a 3-month period, with an option for the HSE to extend it for a further month, and by mutual agreement thereafter.

Under the agreement payment to the private hospitals will be on a cost only Open Book model whereby the hospitals will be reimbursed only for the operating costs properly incurred during the period. The costs that will be covered will be limited to normal costs of operating the hospital. The final cost will be verified by independent firms of accountants appointed by the HSE and the private hospitals and there will be an arbitration mechanism in place in the event of any disagreement. Under the Heads of terms private hospitals are funded to 80% of their estimated monthly costs in advance. The private hospitals combined submitted estimates for April which totalled €115m, therefore €90.2m in total was advanced to them for that month. A balancing payment will be made or funding clawed back depending on the outcome of the cost verification process.

Since the purpose of the arrangement is to provide additional capacity to deal with the impact of the COVID-19 pandemic for which there is no definitive time horizon it is not possible to indicate a precise cost estimate attaching to the arrangement. The cost only open book model is therefore the most effective way of ensuring the arrangement provided the additional capacity necessary and that it is value for money for the State.

Photo of Róisín ShortallRóisín Shortall (Dublin North West, Social Democrats)
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887. To ask the Minister for Health the consideration which he has given to permanently retaining private hospitals in public use in order to accelerate progress towards a single-tier health service in line with Sláintecare; and if he will make a statement on the matter. [5434/20]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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The arrangement between the HSE and the private hospitals, which enables the HSE to have 100% access to the private hospital’s capacity, is one of the emergency measures which were set out in the Government’s Action Plan in Response to Covid-19. As such the arrangement is a temporary one. The arrangement is for a 3-month period, with an option for the HSE to extend it for a further month. Any extension of the arrangement beyond that would have to be agreed by the HSE and the private hospitals concerned. Any discussions regarding an extension would have to be considered in the context of the evolution of the Covid-19 pandemic and the most effective use of resources in tackling it. Therefore, while there is an option to extend the arrangement, it is not intended that it would be permanent.

Photo of Róisín ShortallRóisín Shortall (Dublin North West, Social Democrats)
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888. To ask the Minister for Health the status of negotiations with hospital consultants regarding public use of private hospitals; and if he will make a statement on the matter. [5435/20]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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I, officials of my Department and HSE management have engaged with the consultants representative bodies concerning public use of the private hospitals and related matters.

The contract being offered, a TYPE A 'Public Only' contract, was finalised last month and has been made available to consultants who had been working in the private hospitals. The most recent data submitted to my Department shows that 320 consultants have signed up to the contract to date with a further 61 identified as being likely to, subject to clarifications around a small number of outstanding issues.

Most recently, I had a meeting with the IHCA and a number of the private hospital consultants last Friday at which a number of the remaining issues were discussed with a view to optimising arrangements to support the delivery and continuity of care for all patients as public patients.

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