Consultants’ private healthcare in public settings has ‘ceased’, HSE review finds

Consultants carrying out private healthcare in public settings has “ceased” in line with the rules of their new contracts, a review by the Health Service Executive (HSE) has found.Private care provided by public-only consultants contract (POCC) surfaced as an issue during the summer, when Minister for Health Jennifer Carroll MacNeill clashed with the board of the Rotunda Hospital in Dublin.The Minister threatened the hospital’s funding and indemnity if it refused to comply with the terms of the public-only contract as consultants were still treating private care while on public contracts.The board of the hospital eventually backed down.READ MOREHowever, the revelations sparked concerns among senior health officials and politicians that the practice of private work could be continuing elsewhere in the health service.Mairéad Ryan, of the national human resources office within the HSE, said an initial “verification exercise” regarding the implementation of the POCC had concluded, with a specific focus around “compliance with clause 24″, which relates to private practice in public settings.“This exercise found that previously reported non-compliant service arrangements had discontinued, and all regions provided assurance that private practice in public settings had ceased in accordance with the terms of the contract,” she said.[ How can runaway spending in the health service be reined in?Opens in new window ]Ryan’s comments were made in response to a parliamentary question from Social Democrats health spokesman Pádraig Rice, who called for “more than assurances”.“We need to know exactly what steps are being taken to ensure that every public hospital is compliant with the terms of the POCC,” he said.“This process must be rigorously managed and governed to ensure that reform isn’t blocked by legacy culture or any historic arrangements.”The POCC was introduced in 2023 as a key part of the Sláintecare reforms, which seeks to provide universal healthcare. Under the new contract, senior doctors in hospitals received higher salaries in return for the elimination of rights to treat fee-paying patients in public facilities.Both hospitals and doctors received money from payments made – predominantly by health insurers – in relation to private patients treated in public hospitals. The previous contract allowed consultants to have up to 20 per cent of their workload in public hospitals as private, with consultants being given a transitional period of two years to wind down the private practice.A majority of consultants are now on the new contract, with the HSE stating this is having an impact on the executive’s finances.The elimination of private medical practice in the public system has contributed to hospitals facing a projected income shortfall of nearly €145 million, the HSE said last month.The impact is particularly being felt in maternity care as there are no private maternity hospitals, meaning women will gradually lose to option of private maternity care in the State.