St Vincent’s chief warns over public-private row

The St Vincent's Healthcare Group has said if the publicly funded St Vincent's University Hospital was unable to work in tandem with its adjacent private hospital, the position for dealing with patient demand would be "unmanageable".

The group, which operates the publicly funded St Vincent's University Hospital in Elm Park and St Michael's Hospital in Dún Laoghaire, as well as St Vincent's Private Hospital, is currently in dispute with the Health Service Executive over whether consultants employed in the public institutions on a type B contract can engage in practice in the private facility.

Since 2008, new hospital consultants have been appointed under either a category A contract, which allows them to work only in public hospitals, or on a type B contract, which permits limited private practice in public hospitals.

However, the St Vincent’s Healthcare Group told the HSE in correspondence earlier this month that its legal advice was that, as its private hospital was co-located with the public facility and operated by the same employer, its category B consultants could work in both institutions on its campus.

Full disclosure
Last Wednesday, the HSE's national director of human resources, Barry O'Brien, wrote to St Vincent's Healthcare Group seeking full disclosure on a consultant-by-consultant basis regarding doctors with category B contracts who engaged in private practice in St Vincent's Private Hospital.

He said that summary information provided earlier by the group identifying 95 consultants holding either standard or academic type B contracts was “insufficient”.

The issue of category B consultants in St Vincent's University Hospital was raised by Fine Gael TD Simon Harris when senior figures from the St Vincent's Healthcare Group appeared before the Oireachtas Committee of Public Accounts in January.

A number of other private hospitals in Dublin have contended that St Vincent's Private Hospital enjoys an unfair advantage by being able to avail of the services of consultants with category B contracts employed in the public hospital. In correspondence to the HSE earlier this month, the group chief executive of the St Vincent's Healthcare Group, Nicholas Jermyn, said the 554- bed St Vincent's University Hospital and St Vincent's Private Hospital with its 236 beds complemented each other.

Working in tandem
"The level of patients requiring treatment in the public hospital is reduced by the fact that many patients who have insurance are treated in St Vincent's Private Hospital, as has been the case over the last 30 years.

“If we did not have a private hospital working in tandem, as part of the healthcare group, with the public hospital, St Vincent’s University Hospital would require substantially more beds to meet the needs of patients.”

Mr Jermyn said that since the closure of the emergency department at St Columcille’s Hospital in Loughlinstown last year, St Vincent’s University Hospital had been operating with between 40 and 90 beds over its complement.

“If St Vincent’s Private Hospital was not operating in tandem with St Vincent’s University Hospital, we believe the situation would be unmanageable and even further compromise the public hospital concerning its capacity to deal with patient demand.”

Mr Jermyn said that, at present, based on its current number of beds, the public hospital “cannot meet the demand for services and the gap between the hospital’s ability to provide services versus demand is growing”.