Public and voluntary hospitals made almost €390 million from private patients last year, new figures show.
The figure comes as the Government moves away from a two-tier healthcare system, following the introduction of the public-only consultant contract (POCC), which seeks to phase out private healthcare in the public system.
The implementation of the POCC is seen as key to tackling the core problems of the health service. It is intended to enhance senior decision-maker presence on site, out of hours and at weekends to address long waiting lists and hospital overcrowding.
Figures compiled by The Irish Times through Freedom of Information requests of 45 of the State’s public and voluntary hospitals found they earned a total of €388,727,570 from private patients in 2023.
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Cork University Hospital made the highest amount from private patients at €37,798,663, followed by University Hospital Limerick at €31,233,044.
Senior health sources privately acknowledged the complete implementation of the new contract is likely to result in financial deficits in some hospitals, due to the loss of private income.
However, the sources said this was a gap the State was willing to fill in order to reduce the extent to which a two-tier system exists and to meet the Sláintecare goals.
Under the public-only contract, consultants can be asked to work 8am-10pm Monday to Friday and 8am-6pm Saturday as part of their core 37-hour week. Any private work they do has to take place outside their rostered hours, away from the public facility.
Basic pay under the contract ranges from €217,325 to €261,051 on a six-point scale, with additional pay for on-call duties and overtime, and support for medical education training and research.
Latest figures indicate more than 60 per cent of consultants are on the new contract as of the end of November 2024.
In response to questions, a spokeswoman for the HSE confirmed the private activity levels in public hospitals would be affected “in time”, and there would “be an impact on HSE funding requirements”.
“Consultants who have migrated to the POCC have until the end of 2025 to manage down their private activity,” the spokeswoman said.
“The HSE will engage with the Department of Health, as part of the annual estimates process, to seek to have the future loss of this income stream offset by additional exchequer funding.”
The National Rehabilitation Hospital had no private patients or income, according to the figures released under FOI, while the orthopaedic hospital Kilcreene earned €646,019 and Roscommon University Hospital earned €955,000.
The total amount of money earned by hospitals from private patients was lower in 2022 when €393,450,039 was earned, but higher than the €360,819,149 earned in 2021, which would have been affected by the Covid-19 pandemic.
A similar pattern was observed with the number of patients. A total of 187,683 patients were private in public hospitals last year, down from 193,457 in 2022 and up on the 180,087 in 2021.
Meanwhile, the number of people hospitalised with flu on Monday rose to 984, a 13 per cent rise in just 24 hours. The HSE had anticipated that at least 900 would need treatment in hospital by this week, but there has already been a seven-day increase of 339 patients – 115 of these within a 24-hour period alone.
The rise in patients requiring hospitalisation comes as the Irish Nurses and Midwives Organisation (INMO) said there were 606 admitted patients waiting for beds on Monday morning.
HSE chief executive Bernard Gloster said the demand on services at emergency departments over the Christmas period had increased significantly from last year. He said between December 20th and 27th, 34,400 people attended emergency departments, an increase on 27,800 for the same week last year.
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