Plans to remove private patients from public hospitals under Sláintecare reform proposals will cost the health service up to €800 million per year in lost income when fully implemented or close to €8 billion over a decade, medical consultants have argued.
The Irish Hospital Consultants Association (IHCA) contended that overall, the implementation of all 23 proposals in the Sláintecare reform programme could cost nearly €20 billion over a 10-year period. It described the Sláintecare report's cumulative cost estimate of €2.836 billion as a "thoroughly misleading under-estimation".
Sláintecare is the 10-year programme drawn up by an all-party committee last year to transform the country’s health service. However, the IHCA argued that the cost of implementing the reforms had been “grossly under-estimated”.
“The [Sláintecare] report incorrectly identifies €2.8billion as the cost of implementing all 23 proposals over a 10-year period. In fact €2.8 billion is the cost of implementing the proposals in year 10 alone. The true cumulative cost of implementing the proposals over the initial 10-year period on a phased basis is €19.8 billion, with the cost increasing to €28 billion plus inflation in subsequent decades,” the IHCA said.
Existing income
One key element of the Sláintecare proposals is that private patients should be removed from public hospitals – a move which would lead to both hospitals and consultants with rights to treat fee-paying patients losing out on existing income.
The IHCA set out its assessment of the income loss for hospitals but it did not specifically quantify the loss of earnings for doctors.
The IHCA maintained the removal of the existing private income stream would “cripple the public hospital system”, and said its members had no confidence the Government would make up the difference for the loss of revenue from fee-paying patients.
It warned the elimination of private practice would also cause significant legal and industrial relations difficulties given that 94 per cent of consultants in public hospitals had contractual private practice rights.
It said it would also lead to an exodus of experienced doctors from the public system, and serve only to increase the number of approved consultant positions that could not be filled.
Independent review
Last year the Government appointed a group chaired by Dr Donal de Buitléir to conduct an independent review of removing private practice from public hospitals.
In a submission to this review in recent days the IHCA contended the Sláintecare report was incorrect in suggesting that €649 million would be the cumulative cost of removing private patients from public hospitals over a decade, one of the main proposals in the report. It said €649 million would be the cost of implementing the private practice proposal in year 10 of the programme alone.
“The true cumulative cost of implementing the private practice proposal over the initial 10-year period is €4.5billion based on the report’s phasing schedule. The association believes that the real 10-year cost will be €6.5billion in static terms and €8billion adjusted for inflation. Therefore, the real cost will be closer to €800 million per year when fully implemented.”
