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One week’s notice raised in private hospitals deal

By Mindo - 13th Jul 2020

HSE access to private hospital capacity with one week’s notice, if necessary, is being discussed with the Private Hospitals Association (PHA), the Medical Independent (MI) understands.

Negotiations over a new capacity agreement between the State and private hospitals also involve a possible timeframe of up to two years for the deal to run.

The HSE proposals are part of the ongoing negotiations between its officials and the PHA. The HSE has also proposed to use clinically determined criteria as to when to trigger access to private hospital capacity. The agreement’s timeframe would be subject to review in light of any emerging clinical evidence.

A HSE document, seen by MI and titled Safety Net, broadly sets out plans for “access to physical and service capacity of all or some private hospitals”, as well as access to the “requisite number of consultants to deliver on public service needs”. 

The document lays out plans for private hospitals to deliver a “turnkey solution including consultants” and the facilitation of consultant and team transfers from the public hospital system. 

It adds that the “public funder” may require the following services: Urgent surgery; urgent day cases and treatments; critical care; inpatient non-elective care; Covid care; diagnostics and additional services. 

Contractual arrangements with publicly-employed doctors will be agreed with the Department of Health, the document outlines, while the Department will also “agree arrangements for the procurement of private doctors”.

The State’s previous deal with private hospitals ended last month and proved controversial with many private consultants.

 “Discussions are ongoing,” a spokesperson for the PHA told MI. “We can’t speculate on the details of a potential deal while these are still under active consideration.”

A HSE spokesperson did not comment on the specifics of the negotiations.

However, its spokesperson confirmed it had been charged by the Government to seek “full access to private hospital capacity in the event of a surge of Covid-19 cases and separately with ongoing agreed access to private hospital services to address the HSE’s priority needs in providing both essential care and addressing elective care for public patients experiencing delays.

“This work is currently ongoing and as agreed by Government, the Departments of Health and Public Expenditure are providing support and policy to the HSE in the negotiations.”

Mr Fergal McGoldrick, Orthopaedic Surgeon at the Hermitage Clinic and member of the recently-formed Independent Medical and Dental Consultants Association (IMDCA), was critical of the nature of the current negotiations.

“The doctors are not seen as part of the relationship,” Dr McGoldrick told MI.

“In other words, doctors are brought in ‘by the way’. It is very disappointing to see the same attitude is still pervasive within the Department of Health and the HSE.”

Dr McGoldrick said the Association’s request to Minister for Health Stephen Donnelly was that if the Government was looking to negotiate a long-term rapid-access agreement, “doctors need to be brought into the loop”.

During the first deal, private hospitals did not “obtain any optimisation”, according to the surgeon. “And the reason they didn’t obtain optimisation is, the HSE never negotiated with the doctors who work in these hospitals.”

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