Pressure on private hospitals to agree to Covid-19 surge plan ‘not a threat’, HSE chief says

HSE chief executive Paul Reid has said that its intention to report to Government any private hospitals unwilling to help in a possible second surge of coronavirus was "not intended as a threat".

Some private hospitals reacted with surprise to a letter sent by the HSE earlier this month saying that it would inform the Government if they chose not to engage on a new plan to prepare for a second surge of the virus.

One private hospital manager likened the HSE’s position as “going to tell teacher” if the hospitals did not sign up.

The hospitals were asked to respond to the HSE’s letter by August 14th as part of its plans to negotiate a “Surge II agreement” in order to secure health services in the private hospital should the public hospitals face rising infections.

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“Absent a clear commitment from your hospital on this issue, we will inform the Government that we have done what we can to progress the Surge II arrangements with the private hospitals overall and of your position,” the letter states.

Negotiate

The HSE said the Government would then consider what “needs to be done” if private hospitals were not prepared to negotiate what it described as “a critical arrangement aimed at dealing with an emergency situation”.

Asked about the letter by The Irish Times, Mr Reid described it as a “call to arms” and a required response to what might happen if the virus “just explodes everywhere”.

“We will be looking for their support. They will need our support too. I don’t see it as being a threat to them. It is not intended as a threat or anything like it,” he said.

“It is really just saying that if there is a big call to arms, we want everybody to jump in. I do think that they will need us in a phase like that.”

Mr Reid said that “dialogue is still ongoing” and that discussions were now with individual hospitals rather than with the overall private hospital sector as happened earlier this year with a three-month agreement to take them over.

The last government took over 100 per cent capacity of 18 private hospitals at the end of March, but decided in May not to extend the arrangement beyond the three-moth period.

Concerns were expressed about the €300 million cost of the deal and that the hospitals were not being fully used.

A spokesman for the Private Hospitals’ Association said HSE talks with individual hospitals would “aim to achieve greater flexibility for all concerned and will have the capacity to operate on a regional and local basis as necessary”.

The HSE put forward new proposals to the private hospitals to secure access to their facilities in the event of an another surge. In the HSE proposals – known as the “safety net II document” – the health service said it would assess relevant clinical and capacity criteria to trigger the introduction of a new private hospital arrangement.

Single arrangement

It said the National Public Health Emergency Team would be appraised of the clinical escalation triggers based on clinical service requirements, national or regional coverage and the suitability and capability of the provider.

The HSE suggested it wanted a single arrangement including access to all or some physical and service capacity of private hospitals, based on triggers and access to “a requisite number of consultants to deliver public service needs”.

The HSE proposed that any existing contract the hospitals have with the National Treatment Purchase Fund to treat patients on public waiting lists would be suspended or reviewed for the duration of the new arrangements.

The HSE suggested that private work in private hospitals would be “allowable” but at its discretion and “consistent with safety net need” Any income from private work would be offset against its costs.

It also said that public sector provisions in relation to charging and eligibility would apply to private hospital capacity that was acquired.

The HSE said in an accompanying letter that the virus continued to present unprecedented challenges and it was important that an early understanding was reached on arrangements that could be put in place, by prior agreement, if there was a second surge in cases.

The health service described the plan Surge II document as “a starting point for working towards the sort of broad understanding that is required of all parties by the Government”.