Around 300 of the estimated 600 private hospital consultants in this country haven’t signed up to the COVID-19 contract.
There’s a long list of points to be made, but Dennis O’Sullivan, a consultant urologist (and sheep farmer) working in the private hospital sector wants to highlight the impact this situation is having on Irish people, including farmers, who pay private medical insurance.
“Currently it’s no good to them,” he says. “They can’t get access to private healthcare. While cancer patients are receiving chemotherapy, many are not having the follow-up checks they normally would and people worried about new symptoms are not being seen. They have to go onto the public waiting list or come in to hospital through A&E. People can’t ring up and make an appointment with a specific consultant. People with varying degrees of symptoms don’t even know if the hospitals they want to go to are private or public and whether they are open at the moment or not. There’s fear too that is stopping them going also, of course.”
He can’t understand, however, why patients aren’t being more vocal in the media and elsewhere about this current lack of access.
“They should be giving out to their insurers, for example, saying, ‘You just caved in and didn’t do anything in spite of the fact that we are paying big money’. The insurance companies have just abandoned their patients really,” he says.
If patients did complain more it would help them access private care – if they wanted it at present – and also help the case of the private hospital consultants who haven’t signed what’s called the A contract offered by the HSE as part of the COVID-19 deal with the private hospitals, a deal which may continue until August or beyond.
Wants the HSE to loosen up a bit
So what do consultants like Denis O’Sullivan want?
“We want a contract that would mean more (non-COVID-19) work being done during this period, instead of a backlog building up. I don’t think the private hospitals are busy enough at the moment. A ‘B’ contract would see people like me being able to work on all the patients – public and private – that the HSE transfers over from the public hospitals, and allow us to see our own patients as well, including cancer patients, for example, who come to our clinics.”
From treating 30-40 outpatients a week in his clinic, he was only seeing 10 a week prior to Sunday, 3 May, he says.
“The State indemnity was taken away from us that day, at very short notice, so currently we can’t work at all. We were doing some operations for free but we can’t do that now.”
The reason he doesn’t feel encouraged to sign up to the A contract relates to income drop and also to feeling that the taxpayer is not getting value for money.
“The HSE salary is about €6,500 per month after tax, which is a nice salary if you’ve no expenses but mine, for example, are €20,000 a month, so I’d be left paying the balance of €13,500 myself each month while also working. There are no supports for making up the difference for removing the private practice (from consultants) who sign the A contract. The HSE will only give money if they want to rent rooms for clinics, for instance.”
The taxpayer could be getting better value, he adds. “They could have had a ton more work going through if they’d allowed us see our own private patients too. It would have saved about €40,000 per consultant for the HSE also. Without income from fee-paying patients, with that contract, our practices just wouldn’t be viable,” he says.
He wants the HSE and private hospitals “to loosen up a bit”, he says.
“They should be more interested in their patients than in their bank balances and ideology. All they have to do at this point is change the contracts – that would solve a lot of it.”
Resents lack of negotiation
The chief resentment among these doctors is that they were not consulted when the deal with the hospitals was brokered in April.
“We knew nothing about it… (we got) no apology or whatever for it being done like that (by private hospital managements and the HSE), just shoving us out overnight. You couldn’t do that in any other business.”
But wasn’t this deal with the private hospitals done in exceptional circumstances, for all the right reasons? To battle a pandemic? To free up ICU beds and do non-COVID-19 work?
“The first thing is that they didn’t need them all because they have never all been full around the country,” he responds. “I don’t believe the private hospitals are as busy as they should be, but if you really want to prepare for something, you get talking to people.”
He makes another point – about private consultants who already have HSE contracts.
“Many HSE doctors would already be working in private hospitals. Their contracts weren’t changed at all – that’s the crazy thing – they can continue with their private practice, but the ones who depend totally on private practice for their normal living are being told ‘you can’t work anymore.’”
He also mentions the long term possibilities for health insurance companies.
“Yes, customers have received some refunds but they should be reimbursed for everything. The amazing thing is that none of the insurance companies have objected to what’s happening in spite of the fact that they are supposed to be so caring. This could lead to people giving up their cover in future.”
He believes that insurers may be afraid to say anything because it would be perceived as being against the national interest.
“This is not correct. You can’t stamp on people’s rights because of something that may happen. There will be more people dying from heart attacks, strokes and cancers than from COVID-19, in my opinion, because of the over-hyping of it.
“In Italy and the UK their figures show that one and a half times as many people have died from non-COVID-19 illness as COVID-19. Shutting down private hospitals here is only making it worse.”
HSE
The HSE didn’t directly answer questions about the reluctance to offer a different contract to those consultants working exclusively in the private sector nor about whether or not the current contract was good value for the taxpayer. Figures for work carried out in private hospitals were given however. See below.
Providing time-dependent treatment
“…The available capacity in participating private hospitals is being used to support the HSE in providing time-dependent treatments and procedures to our patients including areas such as cancer and cardiovascular surgeries, transplant surgery, chemotherapy, radiological tests and procedures...
The HSE is being guided by NPHET in terms of its overall response to the pandemic including the volume and types of acute activity that can be safely undertaken in private and public hospitals during the pandemic.
Between the end of March and end of April, based on the information received to date, private hospitals’ activity, under these new arrangements, includes the following:
2,650 inpatient cases, 8,585 day cases, almost 8,000 diagnostic tests and 3,180 outpatient appointments. Services include chemotherapy, radiology, time-dependent procedures such as endoscopy, cardiovascular surgery and cancer surgery. All patients treated under the arrangement are deemed public and are therefore not liable to private charges. In terms of continuity of care, arrangements have been put in place to ensure that those patients who were scheduled for treatment or in on-going treatment had appropriate access to care. Such patients will be seen based on clinical prioritisation and will be deemed public patients under the arrangement.
Irish Hospital Consultants Association
Patients in treatment limbo
“A group of IHCA consultants, met the Minister for Health, Simon Harris, and the Department of Health on 8 May… Again, no agreement was achieved, with the Minister and his officials still not willing to provide consultants with a B or C type contract… It is extremely disappointing that the health service management has failed to provide these contracts to consultants to date.
There is also a lack of clarity now for all patients on their pathway of care… This is leaving patients in treatment limbo and at the risk of increasingly adverse health outcomes for all patients...
Private hospitals are currently operating well below capacity and run a serious risk of being underutilised in the months ahead, if practical solutions are not provided by the Minister.
Health Insurance Authority (HIA)
Check with your insurer
Private Health Insurers are continuing to pay claims for their customers that fall outside the private hospital agreement with the HSE. This includes cover for private care in public hospitals, psychiatric care both inpatient and outpatient, maternity care and addiction treatment and a range of other services and benefits.
For the hospitals that are included in the agreement, Private Health Insurers will cover the public hospital charge for in-patient services of €80 per day up to a maximum of 10 days.
It is important to note that treatment of COVID-19 is free under an infectious disease exemption.
The HIA advises consumers to check with their insurer to clarify what is covered by their policy to find out what services are available to them. More information is available to help consumers on the HIA website : https://www.hia.ie/news/COVID-19-financial-support-measures-introduced-insurers
Private Hospitals' Association (PHA)
Unprecedented challenge
The welfare and safety of patients are the key priorities. Measures are in place to allow for the continuation of treatment of seriously ill patients and emergency surgeries are also taking place.
PHA members recognised at the outset the unprecedented challenge that the COVID-19 pandemic could present to the country’s acute hospital infrastructure and immediately offered to play their part in the national effort to deal with the expected surge in demand for additional capacity.
This was the right decision at that time. Thankfully the curve has flattened considerably in the interim period. The requirement for private hospital capacity is currently under review by the HSE and we await the outcome of that process.
Around 300 of the estimated 600 private hospital consultants in this country haven’t signed up to the COVID-19 contract.
There’s a long list of points to be made, but Dennis O’Sullivan, a consultant urologist (and sheep farmer) working in the private hospital sector wants to highlight the impact this situation is having on Irish people, including farmers, who pay private medical insurance.
“Currently it’s no good to them,” he says. “They can’t get access to private healthcare. While cancer patients are receiving chemotherapy, many are not having the follow-up checks they normally would and people worried about new symptoms are not being seen. They have to go onto the public waiting list or come in to hospital through A&E. People can’t ring up and make an appointment with a specific consultant. People with varying degrees of symptoms don’t even know if the hospitals they want to go to are private or public and whether they are open at the moment or not. There’s fear too that is stopping them going also, of course.”
He can’t understand, however, why patients aren’t being more vocal in the media and elsewhere about this current lack of access.
“They should be giving out to their insurers, for example, saying, ‘You just caved in and didn’t do anything in spite of the fact that we are paying big money’. The insurance companies have just abandoned their patients really,” he says.
If patients did complain more it would help them access private care – if they wanted it at present – and also help the case of the private hospital consultants who haven’t signed what’s called the A contract offered by the HSE as part of the COVID-19 deal with the private hospitals, a deal which may continue until August or beyond.
Wants the HSE to loosen up a bit
So what do consultants like Denis O’Sullivan want?
“We want a contract that would mean more (non-COVID-19) work being done during this period, instead of a backlog building up. I don’t think the private hospitals are busy enough at the moment. A ‘B’ contract would see people like me being able to work on all the patients – public and private – that the HSE transfers over from the public hospitals, and allow us to see our own patients as well, including cancer patients, for example, who come to our clinics.”
From treating 30-40 outpatients a week in his clinic, he was only seeing 10 a week prior to Sunday, 3 May, he says.
“The State indemnity was taken away from us that day, at very short notice, so currently we can’t work at all. We were doing some operations for free but we can’t do that now.”
The reason he doesn’t feel encouraged to sign up to the A contract relates to income drop and also to feeling that the taxpayer is not getting value for money.
“The HSE salary is about €6,500 per month after tax, which is a nice salary if you’ve no expenses but mine, for example, are €20,000 a month, so I’d be left paying the balance of €13,500 myself each month while also working. There are no supports for making up the difference for removing the private practice (from consultants) who sign the A contract. The HSE will only give money if they want to rent rooms for clinics, for instance.”
The taxpayer could be getting better value, he adds. “They could have had a ton more work going through if they’d allowed us see our own private patients too. It would have saved about €40,000 per consultant for the HSE also. Without income from fee-paying patients, with that contract, our practices just wouldn’t be viable,” he says.
He wants the HSE and private hospitals “to loosen up a bit”, he says.
“They should be more interested in their patients than in their bank balances and ideology. All they have to do at this point is change the contracts – that would solve a lot of it.”
Resents lack of negotiation
The chief resentment among these doctors is that they were not consulted when the deal with the hospitals was brokered in April.
“We knew nothing about it… (we got) no apology or whatever for it being done like that (by private hospital managements and the HSE), just shoving us out overnight. You couldn’t do that in any other business.”
But wasn’t this deal with the private hospitals done in exceptional circumstances, for all the right reasons? To battle a pandemic? To free up ICU beds and do non-COVID-19 work?
“The first thing is that they didn’t need them all because they have never all been full around the country,” he responds. “I don’t believe the private hospitals are as busy as they should be, but if you really want to prepare for something, you get talking to people.”
He makes another point – about private consultants who already have HSE contracts.
“Many HSE doctors would already be working in private hospitals. Their contracts weren’t changed at all – that’s the crazy thing – they can continue with their private practice, but the ones who depend totally on private practice for their normal living are being told ‘you can’t work anymore.’”
He also mentions the long term possibilities for health insurance companies.
“Yes, customers have received some refunds but they should be reimbursed for everything. The amazing thing is that none of the insurance companies have objected to what’s happening in spite of the fact that they are supposed to be so caring. This could lead to people giving up their cover in future.”
He believes that insurers may be afraid to say anything because it would be perceived as being against the national interest.
“This is not correct. You can’t stamp on people’s rights because of something that may happen. There will be more people dying from heart attacks, strokes and cancers than from COVID-19, in my opinion, because of the over-hyping of it.
“In Italy and the UK their figures show that one and a half times as many people have died from non-COVID-19 illness as COVID-19. Shutting down private hospitals here is only making it worse.”
HSE
The HSE didn’t directly answer questions about the reluctance to offer a different contract to those consultants working exclusively in the private sector nor about whether or not the current contract was good value for the taxpayer. Figures for work carried out in private hospitals were given however. See below.
Providing time-dependent treatment
“…The available capacity in participating private hospitals is being used to support the HSE in providing time-dependent treatments and procedures to our patients including areas such as cancer and cardiovascular surgeries, transplant surgery, chemotherapy, radiological tests and procedures...
The HSE is being guided by NPHET in terms of its overall response to the pandemic including the volume and types of acute activity that can be safely undertaken in private and public hospitals during the pandemic.
Between the end of March and end of April, based on the information received to date, private hospitals’ activity, under these new arrangements, includes the following:
2,650 inpatient cases, 8,585 day cases, almost 8,000 diagnostic tests and 3,180 outpatient appointments. Services include chemotherapy, radiology, time-dependent procedures such as endoscopy, cardiovascular surgery and cancer surgery. All patients treated under the arrangement are deemed public and are therefore not liable to private charges. In terms of continuity of care, arrangements have been put in place to ensure that those patients who were scheduled for treatment or in on-going treatment had appropriate access to care. Such patients will be seen based on clinical prioritisation and will be deemed public patients under the arrangement.
Irish Hospital Consultants Association
Patients in treatment limbo
“A group of IHCA consultants, met the Minister for Health, Simon Harris, and the Department of Health on 8 May… Again, no agreement was achieved, with the Minister and his officials still not willing to provide consultants with a B or C type contract… It is extremely disappointing that the health service management has failed to provide these contracts to consultants to date.
There is also a lack of clarity now for all patients on their pathway of care… This is leaving patients in treatment limbo and at the risk of increasingly adverse health outcomes for all patients...
Private hospitals are currently operating well below capacity and run a serious risk of being underutilised in the months ahead, if practical solutions are not provided by the Minister.
Health Insurance Authority (HIA)
Check with your insurer
Private Health Insurers are continuing to pay claims for their customers that fall outside the private hospital agreement with the HSE. This includes cover for private care in public hospitals, psychiatric care both inpatient and outpatient, maternity care and addiction treatment and a range of other services and benefits.
For the hospitals that are included in the agreement, Private Health Insurers will cover the public hospital charge for in-patient services of €80 per day up to a maximum of 10 days.
It is important to note that treatment of COVID-19 is free under an infectious disease exemption.
The HIA advises consumers to check with their insurer to clarify what is covered by their policy to find out what services are available to them. More information is available to help consumers on the HIA website : https://www.hia.ie/news/COVID-19-financial-support-measures-introduced-insurers
Private Hospitals' Association (PHA)
Unprecedented challenge
The welfare and safety of patients are the key priorities. Measures are in place to allow for the continuation of treatment of seriously ill patients and emergency surgeries are also taking place.
PHA members recognised at the outset the unprecedented challenge that the COVID-19 pandemic could present to the country’s acute hospital infrastructure and immediately offered to play their part in the national effort to deal with the expected surge in demand for additional capacity.
This was the right decision at that time. Thankfully the curve has flattened considerably in the interim period. The requirement for private hospital capacity is currently under review by the HSE and we await the outcome of that process.
SHARING OPTIONS