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Tense negotiations with private hospitals on Covid-19 surge capacity

By Mindo - 14th Aug 2020

Doctor preparing the coronavirus COVID-19 vaccine. Details of hands and syringe.

The HSE is negotiating with individual private hospitals nationally on capacity arrangements in the event of a Covid-19 surge after a recommendation from the Private Hospitals Association (PHA) stating that this “would be more appropriate”.

The Executive has written to individual private hospitals and is currently “refining its requirements” around capacity and services sought in private facilities, according to a spokesperson for the Department of Health.
Mr Liam Woods, HSE National Director of Acute Operations, wrote to the PHA on 7 August setting out the Executive’s proposal on capacity and services sought in the event of a second surge of the virus. The letter, seen by the Medical Independent, stated: “We anticipate that by close of business on 14 August we will have your full response to the framework document.

“Absent a clear commitment from your hospital on this issue, we will inform Government that we have done what we can to progress with the surge II arrangements with the private hospitals overall and of your position. Government will then consider what needs to be done in the context of your hospital’s unwillingness to negotiate a critical arrangement aimed at dealing with an emergency situation.” The HSE is seeking full capacity at one week’s notice in private hospitals in a 24-month agreement.
It is understood private consultants and hospitals are unwilling to accept this arrangement, but are agreeable to a limited capacity deal.

“Discussions were held between the HSE and the Private Hospitals Association regarding the use of their facilities in the event of a Covid-19 surge. The PHA indicated that they were prepared to support the State in the event of a further surge of Covid-19 cases,” said the Department’s spokesperson. “The PHA has now indicated that its view is that the most efficient way to help the HSE in relation to a possible second wave of Covid-19 is by the HSE undertaking bilateral arrangements with individual private hospitals or hospital groups. The HSE are following up with the hospitals and have written to each of them on the matter.”

Mr Fergal McGoldrick, Orthopaedic Surgeon at the Hermitage Clinic and founding member of the newly-formed Medical and Dental Consultants Association (MDCA), believes there is available capacity within the public hospital system, which is currently lying idle. He said there are empty beds and closed wards in several public facilities that could be utilised if required. If public beds were used more efficiently there would be no need for private hospital capacity, he said.

Some have questioned why private facilities have returned to 90-100 per cent activity levels pre-Covid when public facilities have not.
One consultant told this newspaper: “Even if there is any future agreement… most private consultants are not interested in HSE employment contracts.” Separately, the HSE is in the process of tendering for services in private hospitals to address the shortfall in capacity in public hospitals due to Covid-19.

“The HSE is currently refining its requirements in relation to securing capacity and services to compensate for the shortfall in capacity in public hospitals, due to the safety guidelines developed in line with the NPHET’s expert advisory group’s recommendations,” according to the Department’s spokesperson. “As part of a wider strategy to address this shortfall the HSE is in the process of tendering for services in the private hospitals.  In relation to scheduled care the NTPF has resumed its operations with a view to obtaining increased capacity to deal with waiting list activity.”

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