I take it that the Deputy is referring to the private practice of public hospital consultants employed in public acute hospitals under the consultants' common contract. The provision of private care in public acute hospitals is a long standing feature of the Irish health care system. Over 2,500 beds in public hospitals are designated as private and semi-private. A ratio of 80:20 public/private applies on average across the entire acute system. The percentage of beds designated as private varies between individual hospitals; for example, there is a higher ratio of private beds in maternity and paediatric hospitals and a lower ratio in other hospitals.
Under the common contract, consultants are entitled to engage in private practice within the public hospital or hospitals in which they are employed. The extent to which consultants may engage in off-site practice is determined by the category of post which they hold and is subject to them satisfying the employing authority that they are fulfilling their contractual commitment to the public hospital(s). With regard to on-site private practice, a consultant's overall proportion of private to public patients should reflect the designated ratio of public to private beds.
I am concerned that there are instances where the ratio of private work has far exceeded the stated bed designation. This is a matter which is central to this Government's reform programme, in particular in relation to a new hospital consultants' contract. In this context, I should add that the new consultants' contract, which was accepted by the Irish Hospital Consultants Association on 16 May, will facilitate the appointment of Clinical Directors who will lead and manage consultants, as well as managing clinical budgets and services for patients. The Clinical Director will also have a pivotal role in monitoring compliance with the ratio of public to private practice, and taking corrective action where the private practice limit is exceeded. My Department has requested the Parliamentary Affairs Division of the HSE to arrange to provide the detailed information requested by the Deputy directly to him as soon as possible.