Covid-19: State could take over up to 30% of private hospital capacity

A draft agreement that would allow the HSE to take over up to 30 per cent of capacity in private hospitals to deal with rising cases of Covid -19 has been issued to their operators by the Government.

Legal documents for a deal that could potentially run for 12 months are understood to have been sent out on Wednesday to almost all private hospitals with the exception of Beacon in Dublin.

A spokeswoman for Beacon Hospital said it did not expect to take part in the new agreement with the Government on Covid-19 as it already had in place arrangements with individual public hospitals and the National Treatment Purchase Fund to treat public patients. She said about 20 per cent of capacity at the hospital was currently devoted to supporting the public system and about 50 per cent of those in its intensive care facilities were public patients.

The Cabinet on Wednesday considered proposals to provide indemnity cover for the treatment of public patients in private hospitals as part of any new deal.

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Under the proposed deal the State would effectively take over 15-30 per cent of capacity in the hospitals, depending on the number of cases and the impact the disease was having on the public health system at a particular time.

It is understood that the State could take over more than 30 per cent capacity “by mutual agreement” .

The preference of the Department of Health and the HSE is to use capacity in private hospitals to provide time-critical non-Covid care for public patients.

Normal business

The Cabinet was told in a memo from Minister for Health Stephen Donnelly that the Private Hospitals Association (PHA) and private sector consultants wished to return to their normal business of treating private patients "and therefore limited capacity would be available to meet the State's needs".

Ministers were told that the private hospitals did indicate that they remained prepared to support the State in the event of a further surge.

“In respect of the other services, the PHA indicated that it would be more appropriate for the HSE to negotiate bilaterally with hospitals regarding the provision of capacity to address the other requirements. Subsequently they indicated they were not in a position to conclude an agreement in relation to surge capacity and that the HSE should undertake bilateral arrangements with individual hospitals or groups of hospitals regarding the provision of such capacity.”

The proposed new agreement between the State and private hospitals would be very different to the arrangement put in place last March, which saw the HSE effectively take control of nearly 20 private hospitals for three months during the first wave of the pandemic.

The Irish Times understands that under the proposed new model, any move by the State to take over capacity in private hospitals – and the scale involved – would be triggered by the rate of incidence of Covid-19, the disease’s reproduction number at the time and the overall impact of the surge on the public health system.

Payment

Under the proposal about 15 per cent of capacity could be taken over if Covid-19 levels reached a certain threshold, rising to 30 per cent if the position should deteriorate further.

It is understood that there would be an overall service level agreement between the HSE and the private hospital sector, with some element of payment based on the services provided.

Private hospital practice could continue in parallel with the takeover of capacity by the HSE, unlike the situation in spring and early summer, when private sector consultants, who were not part of the deal at the time, argued they had largely been shut out of the hospitals in which they practised.

It is expected there may be an independent body that would determine whether the scale of any surge had reached the thresholds set out to trigger the takeover of capacity. The arrangement could potentially run for 12 months.

Separately the HSE told trade unions on Wednesday that it was preparing a list that would set out the prioritisation of healthcare staff to receive the Covid-19 vaccine.

It is understood that the HSE is looking at this to be based on the role and function of the personnel concerned rather than their grade, as well as the proximity of where they work in relation to confirmed and suspected Covid cases.