Forcing hospital consultants to prioritise public patients over private ones will "probably make things worse" in the health service, the assistant general secretary of the Irish Hospital Consultants Association has warned.
While he welcomed the thrust of yesterday's reports, Mr Donal Duffy said he disagreed with "certain assumptions" made "without supporting evidence" by the Brennan Commission.
"There has been a focus on public-private mix as the root of all evil. But you have to remember 50 per cent of the population have private health insurance. Why are they doing that? Because the public system is not delivering."
He said an assumption made by the Brennan report was that "consultants are not doing what they are supposed to be doing. In fact, consultants are doing well above and beyond what is expected of them. Their workload is well in excess of the OECD average."
Putting further restrictions on private practice "is not going to solve the problem and will probably make things worse," Mr Duffy added. Hospital waiting lists would remain unchanged, yet people would be less likely to take out health insurance. If this occurred revenue would have be raised through further taxation.
Of the proposal to re-introduce "public-only" contracts, Mr Duffy said the IHCA did not oppose this so long as it was available to everyone. However, the Brennan report was "unclear" as to the nature of these contracts and their implications for A&E cover.
The Irish Medical Organisation was more enthusiastic about the proposal, saying it had been the only party at the last round of consultant talks to argue for the retention of public-only contracts.
However, the group's chief executive, Mr George McNeice, said it would be arguing that this option needed to be "priced accordingly", and made available along with the current contract under which consultants could combine public and private medical practices.
As a matter of principle, he said the IMO would continue to insist that contract changes for consultants, general practitioners and others were discussed and freely negotiated within established industrial relations processes.
Welcoming the publication of the reports, Mr McNeice added "for too long, our health services have suffered from increasing bureaucracy".
The Irish Nurses Organisation also welcomed the proposed organisational reforms, saying they appeared to have the potential "to both speed up decision-making and empower front-line staff" by creating a flattened management structure.
However, it said, the Government must now complete the reform process by providing all the necessary investment to allow for the implementation of the Health Strategy, including extra beds and enhanced primary care services.
The Office for Health Management, an umbrella group of professionals in the sector, emphasised the need for proper consultation and careful management of the reforms. Its director, Mr Denis Doherty, said "throughout the transition period it is vital that the service to patients is protected and maintained and that nothing is done to damage staff morale and welfare."
