Consultant told to pay €100,000

A HOSPITAL consultant has been told to pay a “financial penalty” of more than €100,000 for treating too many private patients…

A HOSPITAL consultant has been told to pay a “financial penalty” of more than €100,000 for treating too many private patients.

A number of other consultants have also been invoiced by management in the Health Service Executive over the breaching of official limits on the levels of private practice set out in their contracts.

Depending on their type of contract, consultants can either see a maximum of 20 per cent or 30 per cent of private patients.

However, over the last year the HSE has argued that a number of consultants were not in compliance with the terms of the public-private mix in their new contracts.

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Last August the HSE signalled it planned to warn officially 35 hospital consultants that they could face sanctions for treating excessive numbers of the fee-paying patients. It has now begun issuing formal invoices to a number of consultants setting out amounts which it believes they should now pay into a special research fund.

Well-placed sources said that one consultant had been sent an invoice for more than €100,000.

The Irish Hospital Consultants Association is challenging the methodology used by the HSE in calculating the level of private practice. It has said the system adopted by management in the health service is “fundamentally flawed”.

It is understood that the consultants who have now received invoices are those where the HSE contends private patients account for 50 per cent or more of the total number treated.

Under the terms of the contract the HSE can seek consultants found to be persistently in breach of official private practice limits to pay fees arising from the private patients over and above the threshold into a research and study fund.

It is understood the invoices sent out in recent days relate to a six-month period in 2010 as well as an additional three-month period in which consultants are allowed to bring their level of private practice back into line.

In regulations introduced last year the HSE stated: “Once the medical consultant and the employer are agreed regarding total private fee income, an amount of private fee income to the extent to which the medical consultant has exceeded the specified ratio will be identified.

“For example, should the medical consultant have exceeded the specified ratio in a particular segment of practice (inpatient, outpatient, day case or otherwise) (eg engaged in 30 per cent private practice instead of the specified ratio of 20 per cent), the amount of private fee income above the 20 per cent threshold in that segment of practice (inpatient, outpatient, day case or otherwise) will be recouped.”

The HSE has declined to comment on the invoices sent to consultants. A spokesman said that “this issue remains a work in progress and it would be inappropriate to comment at this time”.

Martin Wall

Martin Wall

Martin Wall is the former Washington Correspondent of The Irish Times. He was previously industry correspondent