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Animosity within profession over private hospital deal

As the work to limit the spread of Covid-19 continues, a significant divergence has emerged among hospital consultants. Niamh Cahill reports

The agreement reached between the State and the Private Hospitals Association (PHA), allowing 19 private hospitals to effectively be used as public hospitals, has led to great animosity, not only between private hospital consultants and Government, but within the profession itself.

The IHCA has already lost a valuable leader in former Vice President Dr Laura Durcan, after she resigned from the role a few weeks ago following an alleged onslaught of “abuse” and “harassment” directed at her by private consultants. The resignation comes as a blow for the Association, although Dr Durcan will stay on as Chair of the IHCA’s new-entrant committee.

Now, full-time private hospital consultants have established a new Association in response to ongoing frustration at the representation provided to them by existing medical unions. 

The Independent Medical and Dental Consultants Association (IMDCA) is the name of the new body. It intends to officially open membership in the coming weeks.

The IMDCA already has 255 members and its articles of association are currently being devised, a senior full-time private consultant told the Medical Independent (MI).

A core committee of 17 individuals is in place and leadership roles are being determined. The Association will represent full- and part-time consultants in private practice, including dentists.

Full-time private consultant Mr Fergal McGoldrick, Orthopaedic Surgeon at the Hermitage Clinic, said: “We are forming the Association in response to what’s happened over the past eight weeks.

“We feel the IHCA and the IMO have not adequately represented us and have not been forceful enough. We have been hung out to dry,” Mr McGoldrick told MI.

“We have been bulldozed into a deal and effectively put out of work, without being able to provide continuity of care to our patients.”

Another private consultant informed this newspaper that the Association was being formed because they had become “disillusioned” with current union representation.

A spokesperson for the IHCA said the union continues to “engage with the Department of Health and HSE” in seeking more flexibility and less costly contract types for full-time private consultants.

Following an unsuccessful meeting on 8 May between IHCA officials, which included private consultants, with Minister for Health Simon Harris, the spokesperson said “it is disappointing that the Minister and his officials continued to offer only a type A contract or contracts for service where a practice is incorporated”.

“It was strongly emphasised by the delegation, directly to the Minister and his senior officials, that this contract type flexibility is essential to ensure continuity of care for WTPP [whole-time private practice] consultant patients in outpatient clinics and their follow-on hospital care where urgently required.”

Resignations from contract

Meanwhile, a number of full-time private consultants have resigned from the temporary contract established by Government in response to Covid-19.

According to the Department of Health, around 320 private consultants out of a total 600 consultants nationally have accepted temporary contracts, which expire at the end of July.

However, reports have emerged that many of these consultants have submitted their intention to resign from the contract, with sources suggesting around 15 consultants in Kerry alone have submitted resignation letters, along with others in Dublin.

Around 97 per cent of the approximately 60 full-time private consultants at Bon Secours Hospital, Cork, have signed the temporary contract, but many of these are considering stepping away from the deal, it is understood.

This is because many say they cannot provide care to their existing private patients under the arrangement. Furthermore, they are unable to accept new referrals and bed occupancy in private hospitals remains low.

On 25 May, bed occupancy in HSE-run private hospitals was just 35 per cent, according to Hospital Inpatient Inquiry data published by the IMDCA.

There are also concerns about the offer made to consultants who were initially reluctant to sign-up to temporary contracts.

Some private hospitals assured consultants that if the HSE did not agree to cover the costs of their private clinic rooms while they undertook State work, that the hospital would issue payment if the consultant signed the contract. 

However, MI understands that to date, some consultants have received no payments covering costs for their private rooms.

Meanwhile, a decision is due shortly on whether the deal between the HSE and PHA, brokered in March, will be extended. The current agreement ceases at the end of July.

HSE CEO Mr Paul Reid, based on recent comments, appears eager to retain capacity in private hospitals in case of future surges of the novel coronavirus.  However, following the decline of Covid-19 in the community, others believe there is little medical or cost basis to continue the arrangement. 

As a compromise, it has been suggested that some private hospital bed capacity could be retained by the public system after the current deal ends.

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