Secretary General warned of ‘white flag’ being raised in relation to off-site private practice

The Secretary General of the Department of Health expressed concern that health management was waving the “white flag at a very early stage” in relation to permitting off-site private practice in any future consultant contract for public hospital work, the Medical Independent (MI) can report.

The Report of the Independent Review Group established to examine Private Activity in Public Hospitals, which was published in August, stated that while it was preferable that consultants employed in the public health service were fully dedicated to their public commitments, any arrangements to work off-site when their main commitments have been fulfilled should be subject to the prior approval of hospital management.

According to the report, this should only occur when there is no potential risk to patients and should prioritise the interests of public patients in public hospitals.

In his comments on a draft memo prepared for Government on the report, obtained by MI through Freedom of Information law, Mr Jim Breslin said his “major feedback” was in relation to off-site practice and that he was concerned “that we are waving the white flag at a very early stage without identifying the difficulties with this”.

“I think we need to explore the fact that in the past, there was a modest differential between public-only and other contracts — give the intended 2008 [consultant contract] differential, but acknowledge that because increases weren’t implemented the public-only was not attractive,” according to Mr Breslin.

“We have the option of making public-only attractive by eliminating public/private, leaving the choice between public-only and private-only. This does inform consideration of the salary required to attract people to public-only, but also other financial (ie, pension) and non-financial (teaching, research, specialisation, etc) benefits.”

A briefing note for the Minister for Health, also obtained by this newspaper, refers to “a considerable number of complex issues” that arise as a result of the report’s recommendations.

“These include legal, operational and financial implications that require further consideration. This consideration of the report by Department officials is ongoing and covers a range of issues, which have also been discussed in engagement with the Department of Public Expenditure and Reform and the Department of the Taoiseach.”