Mental health body warns over fee cuts

THE MENTAL Health Commission has warned the Government that the imposition of further cuts in professional fees could cause it…

THE MENTAL Health Commission has warned the Government that the imposition of further cuts in professional fees could cause it difficulties in securing consultant psychiatrists to serve on mental health tribunals.

Mental health tribunals carry out a review of cases of persons admitted involuntarily to psychiatric hospitals. By law, a consultant psychiatrist must be a member of each tribunal. Consultant psychiatrists also carry out independent medical examinations and prepare case reports.

Last year, the Department of Health introduced an eight per cent cut in fees paid to consultant psychiatrists for work carried out as part of mental health tribunals. This formed part of a move to reduce professional fees across the health sector. Consultant psychiatrists receive around € 400 per case for serving on tribunals and around € 500 per case for providing independent examinations.

The department decided to keep the reduced fee for psychiatrists in place following a review carried out in June.

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The department is currently assessing whether professional fees across the health sector – with the exception of the community pharmacy sector – should be further reduced as part of a Government plan to save € 45 million in this area.

In a submission to the department, the chief executive officer of the Mental Health Commission, Hugh Kane, said from an operational perspective the impact of the cuts introduced in 2009 had been “minimal” for the commission.

“However, should there be a further reduction in fees following the up-coming review [the current assessment on whether fees should be cut further], this may impact on the recruitment of consultant psychiatrists for the mental health panels,” he said.

In a submission to the department last month, the Irish Medical Organisation (IMO) said there was no justification for further fee cuts.

IMO chief executive George McNeice said the fees paid for such work, which was in addition to the consultants’ regular duties, had never received a structured review. He argued the fee provided to consultant psychiatrists was significantly lower than that paid to other professionals in mental health tribunals.

“The fee is structured on a per case basis and takes no account of the significant variance of time required for each individual case – such times can vary from two hours to nine hours,” he said.

It should be noted, he added, that when cases are heard outside of the psychiatrist’s normal geographical working area, “the time commitment increases significantly”.