HSE may cut funding to two hospitals

The HSE is planning to cut all capital or development funding to St Vincent’s and St Michael’s hospitals in south Dublin as well as to suspend their rights to appoint new consultants and refuse to sanction further lines of credit if their governing board does not agree to a process to stop senior doctors paid by the State working in its private hospital.

In what is building up to potentially the biggest clash between the State and a voluntary hospital, the HSE is also understood to be looking at plans to withdraw medical specialities and related funding from hospitals in the St Vincent’s group and assign these to other institutions.

The HSE has accused the St Vincent's Healthcare Group of seeking to mislead it on the extent of the practice of consultants employed in its public hospitals working also in St Vincent's Private Hospital.

In a letter to the chairman of the St Vincent's Hospital Group, Prof Noel Whelan last Thursday, HSE director general Tony O'Brien set a deadline of today for it to reply to demands for a process which would see such consultants cease private practice in St Vincent's Private Hospital.

The Irish Times understands that the HSE is planning to impose significant sanctions on the St Vincent's Hospital Group, which operates the two public institutions, St Vincent's University Hospital in Elm Park and St Michael's in Dún Laoghaire as well as St Vincent's Private Hospital. unless it receives a reply it considers to be satisfactory response. Highly placed health service sources suggested the HSE would also "take steps to ensure that private insurers review their relationships with St Vincent's Private Hospital vis-a-vis individual consultants".

The St Vincent’s Hospital Group last night signalled the row could end up in the courts. The dispute, in essence, centres on whether consultants employed in the public hospitals on a particular contract known as type B can engage in practice in the group’s private facility. Since 2008, new hospital consultants have been appointed under either a category A contract, which allows them to work only in public hospitals, or on a type B contract, which permits limited private practice in public hospitals. However, the St Vincent’s Healthcare Group told the HSE earlier this month that its legal advice was that, as its private hospital was co-located with the public facility and operated by the same employer, its category B consultants could work in both institutions on its campus.

Legal opinion
A spokesman for the St Vincent's Healthcare Group said: "We would expect that the resolution of differences in legal opinion in the interpretation of the consultants contract would be resolved where differences in legal opinion are normally resolved, through some form of judicial process."

The St Vincent’s Healthcare Group has indicated to the HSE that 95 consultants employed in its public hospitals also carry out private practice in St Vincent’s Private Hospital. However it suggested that not all would have category B contracts and that some, for example, could be academic consultants.

Highly placed health service sources said the HSE was “appalled” at only learning the extent of these private practice arrangements in recent weeks.