Minister for Health Simon Harris TD has today published the Report of the Independent Review Group established to examine private activity in public hospitals.
The Independent Review Group was established by the Minister for Health to conduct this analysis following the recommendation by the All-Party Oireachtas Committee on the Future of Healthcare that private activity be progressively removed from public hospitals and that an independent impact analysis of the separation be conducted.
Following publication of the report, Minister Harris said,
I welcome the publication of this Report and thank the Independent Review Group for conducting this analysis of private activity in our public hospitals.
It is clear that removing private care from public hospitals is complex, would take time and would cost money. Developing a single-tier public hospital system is one of the fundamental reforms envisaged in Sláintecare and decisions on expenditure including on the issues raised in the Report must be made in the context of the wider implementation of Sláintecare and the Public Service Stability Agreement 2018-2020.
I intend to consult with key stakeholders and my colleagues in Government to consider further key implementation issues and return to Government in due course.
The Independent Review Group, which was chaired by Dr Donal de Buitléir, made eight recommendations which it considers would be necessary to remove private activity from public hospitals.
Five recommendations concern the consultant contract. A sixth recommends legislation to ensure that public hospitals are exclusively used for the treatment of public patients from the conclusion of the ten-year Sláintecare implementation period. Two further recommendations relate to better data collection and HIQA’s role in private hospitals.
The Minister continued:
The Independent Review Group has suggested a small number of policy actions which would start the journey towards a fairer public hospital system that exclusively treats all public patients in an equitable and fair manner. Undoubtedly, implementing the recommendations poses some difficult choices but it is clear that this would be a significant step towards achieving single tier health care for all public patients envisaged in Sláintecare.
Two further analyses, by the OECD which examined private activity in an international context, and by Deloitte analysing the impact of the proposal on private health insurance have also been published today. Separately, an analysis by the ESRI of activity in public and private hospitals in Ireland, 2015 was previously published as a Working Paper by the ESRI.
Notes to the Editor
The Report of the Independent Review Group is available on the Department of Health website, along with the OECD and Deloitte analyses.The ESRI examination of activity in public and private hospitals in Ireland, 2015, Working Paper No. 601 is available here.
The Independent Review Group was established following a recommendation by the All-Party Oireachtas Committee on the Future of Healthcare that an independent impact analysis of the separation of private practice from the public system should be conducted.
The Independent Review Group was chaired by Dr Donal de Buitléir, chairman of the Low Pay Commission and former HSE Board member. The other members of the Group were
- Alan Ahearne, Professor of Economics, NUIG and Central Bank Board member
- Ann Doherty, Chief Executive Cork City Council; former HSE National Director
- Nuala Hunt, Chartered Accountant
- Barry O’Brien, Director of Human Resources UCC; former HSE National Director HR
Recommendations of the Report of the Independent Review Group
- Introduce legislation to ensure that public hospitals are exclusively used for the treatment of public patients from the conclusion of the ten-year Sláintecare implementation period.
- All new consultant appointments should be to a Sláintecare Consultant Contract, which allows only public activity in public hospitals
- Restore pay to pre-October 2012 pay levels for all existing Type A contracts and new entrant Sláintecare Consultant Contracts
- Consultants holding 2008 (or earlier) contracts under which the consultant conducts private activity on a public hospital site should be offered a “contract change payment” to move to the new Sláintecare Consultant Contract
- Introduce a scheme to allow a special derogation from pay caps to address recruitment to highly specialised posts
- The Department of Health should ensure that HIQA’s quality and safety regulatory functions are extended to all healthcare settings
- Comprehensive data should be collected on the nature and scale of activity in the private hospital system equivalent to those collected in the public system
- Implement the agreed monitoring and reporting system to robustly monitor and enforce the existing consultant contract