Co-location a disguise for privatisation, debate hears

A MOTION opposing the idea of co-located hospitals was last night passed following a public debate at University College Cork…

A MOTION opposing the idea of co-located hospitals was last night passed following a public debate at University College Cork (UCC).

Proposing the motion, chairman of the Irish Medical Organisation GP Committee Dr Ronan Boland said the rationale offered by the Government for co-location, namely to free up public beds in public hospitals, was a smokescreen.

"It masks the real rationale – the ideology which is allowing by stealth the privatisation of our health service without any real debate, without any societal consensus and without any political mandate," he said at the second in the 2009 Pfizer Health Debates Series in association with The Irish Times.

The debate on the motion that "this house agrees that hospital co-location is neither financially viable nor ethically sound" was chaired by assistant editor of The Irish TimesFintan O'Toole and attracted an invited audience of some 100 people.

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Dr Boland said one of the attractions to general practice for him was that everyone was treated equally, irrespective of their wealth or poverty, and it was no coincidence that every survey found that GP services enjoyed the highest levels of public satisfaction.

Beacon Medical Group (BMG) chief executive Michael Cullen, whose company is involved in building co-located facilities, said Ireland currently had 20 per cent fewer beds than the OECD average and the situation was set to worsen as the number of over-60s doubles by 2020.

BMG’s three proposed co-located facilities would be capable of treating 30,000 in-patients and 48,000 day patients per annum, substantially relieving the pressure on public services, and they will cater for the same case-mix as in public hospitals, he said.

The State would gain not just through the freeing-up of public beds occupied by private patients in public hospitals but also through obtaining substantial rent and a percentage of revenues, while the proposal will also inject €800 million into local economies, he added.

Seconding the motion, Dr Christine O’Malley said that, on paper, co-location ticks all the right policy boxes through drawing entrepreneurs into the public sector, and introduces efficient and cost-effective practices from the corporate commercial sector.

Co-located hospitals would be legally obliged to take the same case-mix as public hospitals, including insured patients from AE – this would mean a full trauma service even if they haven’t the staff.

If the private hospital does employ more doctors, costs will soar and it will not be financially viable as the health insurers do not pay extra for emergencies – and if they did, health insurance would have to skyrocket to US levels, she warned.

However, UCC economist Brian Turner argued that public patients would gain from co-location through the provision of 1,000 extra beds, while private patients will lose through having to pay higher private health insurance premiums.

The addition of the 1,000 public patients would reduce waiting times and improve the lot of public patients, he said.

Barry Roche

Barry Roche

Barry Roche is Southern Correspondent of The Irish Times