Public patients should be given access to private hospitals for the next month to help alleviate the escalating waiting lists, an Oireachtas committee has heard.
The secretary general of the Irish Hospital Consultants Association (IHCA) said there has been a “very low” private hospital bed capacity occupancy, at around one third on average.
A contract which saw the state taking over private hospitals for 115 million euro a month will finish at the end of June.
Martin Varley said the private hospital agreement represents “very poor value for money” from patient care and taxpayer perspectives.
Dr Anthony O’Connor, a member of the Irish Medical Organisation (IMO) consultants’ committee, told the special Covid-19 Oireachtas committee that the private hospitals should be “utilised” in the last few weeks to have an impact on the waiting lists.
He added: “We started with 700,000 people on the waiting lists for hospital care and by the time we get back to work we are going to be dealing with at least six months’ pent-up demand and less capacity to deal with it.
Public patients have been completely locked out of care and are likely to remain so for the foreseeable future. We really need to see a roadmap for which that care can open upDr Anthony O'Connor
“Public patients have been completely locked out of care and are likely to remain so for the foreseeable future.
“We really need to see a road map for which that care can open up.”
The coronavirus death toll in Ireland rose to 1,658 on Tuesday after a further eight deaths were announced.
There were 10 new confirmed cases of Covid-19 in Ireland, bringing the total since the outbreak began to 25,066.
Mr Varley told the committee that the private hospital contract is “prohibiting” the provision of urgent care required by patients with non-Covid-19 illnesses.
“This is leading to the accumulation on waiting lists of a large number of patients who require urgent care,” he added.
“There is now the additional risk that these patients will deteriorate clinically and will increasingly evolve into emergency cases if they are not treated without delay.”
He added that they have “lost the opportunity” to use the capacity during a vital time.
“We’ve paid dearly for that,” he said.
Sinn Fein health spokeswoman Louise O’Reilly questioned whether there was a ‘plan B’ agreed between the state and private hospitals if the Covid-19 surge did not happen and the full capacity not used.
This is a serious concern Govt already had unacceptably high waiting lists for both adults and children While publichealth measures were necessary the capacity in the private hospitals (which we will be paying for in June) should be used to help restart noncovid healthcare— Louise OâReilly TD for Dublin Fingal (@loreillysf) June 1, 2020
She said: “Was there a plan to ensure that we got some value for money, was there ever a plan B by the HSE or the Department of Health?”
Mr Varley responded: “For two very significant reasons we are going to see a higher waiting list. First and foremost the impact of providing care to Covid-infected patients has changed the situation in hospitals.
“That’s going to give rise to very significant increases in public waiting lists but in addition we have waiting lists now in private hospital settings that we would never have had before.
“We have not been flexible, we have not been agile enough and innovative enough in actually dealing with this agreement to allow us to treat more patients.”
Social Democrats co-leader Roisin Shortall said: “I think it’s regrettable that the decision was taken by Government to end the arrangement. There was huge potential.
“In the context of no distinction being made between public and private patients in the treatment of Covid patients, it would be great to see the same effort made in relation to non-Covid care and a single list being operated and all the capacity being used until the end of the year.
“Real progress could have been made through the waiting list for all patients.”
Susan Clyne, chief executive of the IMO, called for an “urgent” assessment of current capacity in hospitals.
She said: “There must be immediate investment to recruit and retain doctors to work in the health service, including targeted measures to address our unprecedented number of consultant vacancies, which now stands at over 500 posts.”
She said that due to the cancellation of all non-urgent care across the system, 570,000 people are still waiting for an outpatient appointment and a further 230,000 people are on a waiting list for an inpatient or day-case procedure.
“Cancer screening programmes have been put on hold and GP access to diagnostics and referral pathways for all patients have effectively been closed down,” she added.
She told the committee that there will be an “inherent reduction” in capacity of up to 50% when new measures are in place.
Dr O’Connor also said: “People talk about a second surge and what might happen – they say we could have hundreds of people lying on trolleys, we could have overburdened ICU capacity, operating theatres closed – that’s January in the Irish health service every year. What could be coming if we don’t address it could be apocalyptic.”
It emerged during the second session of the Covid-19 committee that the use of private hospitals cost 97 million euro in April, while the total projected cost is expected to be 300 million euro.
Department of Health secretary general Jim Breslin also confirmed that no cost-benefit analysis was carried out.
“There was an options appraisal on the different means of securing this capacity,” he added.
“We put in place a cost-recovery model where private hospitals have to produce their accounts to show they incurred the costs.”
However, Sinn Fein’s David Cullinane said less than half of private hospital capacity was used.
Mr Breslin added: “We anticipated we potentially might (have to use full capacity) and we didn’t want to be in a situation where we didn’t have access to it.
“We didn’t have any other beds, we had all of the public beds that we needed and there were no other beds on the island that we could get access to.”