Lack of private practice monitoring described as "shocking"

Sinn Féin spokesperson on Health, Deputy David Cullinane TD, has criticised what he says is the Minister for Health’s scattered approach to private practice in public hospitals.

The Waterford TD said the HSE audit of public-only practice shows the shallowness of the minister’s strategy, which he claims focussed on an isolated incident instead of driving deep reforms to separate private practice entirely from the public system.

“The Public Only Consultant Contract is one tool, and the most important tool, for removing private practice from public hospitals," said Deputy Cullinane.

"It is also essential for increasing evening and weekend activity, offering greater flexibility for appointments and making greater use of existing infrastructure to deliver more care," he added.

“This audit is a damning indictment of the Minister for Health’s lack of focus on actual delivery in the health service, which is underlined by a lack of targets, accountability, and oversight in the implementation of the public-only contract, and the monitoring and reduction of private practice in public hospitals."

Deputy Cullinane said public-only contracts were devised for a reason, commenting: "They are meant to end private practice in public hospitals, strengthen public capacity, and ensure that public hospitals and public resources are used for public healthcare."

“Instead of having a real, comprehensive, hospital-by-hospital overview and plan for maximising public care and removing private practice, this audit has revealed a serious lack of data, oversight, and accountability," he said.

"It is extraordinary that there is still no structured system at national or regional level to monitor the phasing out of private work in public hospitals," he added. 

He said it was an example of agreement to a policy, an announcement made but failure to ensure implementation.

"This is par for the course when it comes to Fine Gael," he said.

"Meanwhile, taxpayers are paying for this highly paid contract without any assurance that the public health service is getting the full benefit of it," he added.

He said public-only contracts need to be looked at in terms of the overall system and not just "through the lens of one hospital or specialty".

Deputy Cullinane said there was lack of accountability on the matter and that there was a need for a more hands-on approach in driving system-wide reform.

He also said it's not an isolated issue: "It comes alongside spiralling agency and outsourcing spending, weak financial control, and repeated examples of poor oversight and inefficiency across the health service."

“The Minister should bring forward a clear plan to separate private care from public hospitals [and] drive full uptake and full use of the public-only contract," he said.

He also said proper data collection must be ensured in addition to deployment of the public-only contract, oversight of private practice across all contracts in public hospitals and clear accountability for removing private practice as far as possible.