Hospitals were warned by the head of the National Treatment Purchase Fund (NTPF) yesterday that it will refuse to pay for any procedures they carry out above an agreed quota.
The warning from the fund's director, Ms Maureen Lynott, comes amid concerns hospitals are trying to carry out as many procedures as possible under the fund to boost their finances.
Ms Lynott said the fund, which has a budget of €31 million this year, had entered agreements with health boards and hospitals to refer 50 per cent of patients eligible for treatment under the fund to private hospitals in the Republic and 25 per cent to private hospitals in the UK. They could do 25 per cent of the work themselves if they had spare capacity and "in no way disrupted or interfered with public hospital and public patient activity". She said her office monitored monthly returns from the hospitals to ensure these agreements weren't breached. However, it appears public patient activity may be disrupted by the work of the fund.
Despite having acutely ill patients waiting for up to five days for admission from its casualty department, Dublin's Mater hospital began treating NTPF patients this week. It hopes to treat 600 to 700 "long waiters" over the coming months as resources become available to carry out ear nose and throat, eye and plastic surgery operations.
However, yesterday there were 20 patients waiting for admission in the Mater's A&E unit. Hospital sources confirmed the hospital has had to go "off-call" for some hours daily for the last few months, when the number of people waiting for a bed reaches 25 or when its ability to adequately resuscitate patients is compromised. Ambulances are requested to bring patients to either James Connolly Memorial Hospital in Blanchardstown or Beaumount hospital during these periods of overload.
Although medical sources indicated that part of the hospital's former medical assessment unit - designed to relieve pressure on the accident and emergency resources - was being used to treat NTPF patients, this was denied by hospital management.
"The hospital is so full of medical patients that our medical assessment unit is all over the place", an administrative source told the Irish Times.
Ms Lynott said if hospitals such as the Mater didn't honour the agreement they had with the NTPF, it would "withdraw from the agreement" or "not pay" for the work it carried out.
The NTPF, announced yesterday that it has arranged treatment for some 5,500 patients, including 874 children, some of whom had been on public waiting lists for eight years.
The fund was set up to remove "long waiters" from hospital waiting lists.
The fund initially identified over 8,300 adults waiting more than a year and children waiting more than six months for treatment on hospital waiting lists.
It expects all these patients to be cleared from waiting lists by the end of this year. Then it will focus on people who became "long waiters" over the past year.
It is arranging treatment for more than 500 patients a month, but referrals to hospitals in the UK have been disappointingly low. Ms Lynott has encouraged people on waiting lists to consider getting treatment in the UK, emphasising their travel arrangements will be met by the fund.