Hospital consultants face audit over private-practice rules

HSE told minister that contract deal had become a farce

Medical examination: private patients can make up no more than 30 per cent of a doctor’s cases. Photograph: E+
Medical examination: private patients can make up no more than 30 per cent of a doctor’s cases. Photograph: E+

Hundreds of hospital consultants are to face audits to check if they are complying with rules governing private practice and other contractual obligations.

An agreement between the government and consultants in 2008 limited the number of private patients that consultants in the public system can treat, depending on the type of contract they hold. Concerns have been raised about whether the rules are being adhered to.

In 2015 the head of the HSE told the minister for health that the rules’ application to senior doctors had become a farce. In a confidential email to Leo Varadkar, Tony O’Brien also said that large voluntary teaching hospitals were in some instances breaking the rules in the way they recruited consultants.

The 2008 agreement stipulated that private patients could make up no more than 20 or 30 per cent of cases for doctors in public hospitals. In his email Mr O’Brien said the percentage rule was “a farce in practice”.

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The HSE said yesterday that it had started to audit the extent to which consultants were “compliant with contractual requirements relating to public and private practice, working hours, delivery of standard duties and responsibilities, reporting to a clinical director and other matters”.

It added: “This exercise currently encompasses approximately 17 per cent of consultants nationally across the range of specialities, hospital groups and community health organisations, and it is intended to review roll-out to further groups of consultants once data has been analysed.”

About 3,000 consultants are employed across the public health system. The new audits are separate from the investigation that the HSE has commissioned into private practice at St Vincent’s Healthcare Group hospitals, in south Dublin.

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.