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The Health Services Executive (HSE) has proposed to assume up to 40 percent of the activity in private hospitals, potentially for two years, to deal with further increases in Covid-19 cases.
It is understood that under their proposals, the HSE is seeking private hospital facilities to provide complex “time-dependent” medical and surgical treatment for public patients in a non-Covid environment.
However, in some cases, Covid-19 patients would be treated in private hospitals under the HSE proposals.
The HSE said on Friday it was “collaborating with private hospitals to provide services at several different levels.” He did not respond to questions about how many private hospitals have accepted his proposals so far.
The HSE said areas in which it was engaging with the private sector included: “A safety net agreement for activation in the event of an extreme rise in Covid-19 in the near future. It is designed to facilitate a rapid response to the challenges this situation would present to patients, private hospitals and the HSE.
“Second, due to the ongoing impact of Covid 19 on services and, in particular, the restricted ability of hospitals to provide non-Covid care, the HSE has tendered for services from private hospitals to provide different services. to support the public health system in the provision of services and guarantee continuity. Some examples of these services include: provision of inpatient care and treatment for urgent and time-dependent care, scheduled inpatient care such as orthopedics, outpatient services, and access to diagnostic services.
The HSE proposals have been criticized by physicians working in the private sector for being “ill-thought-out” and not fully understanding that private hospitals are currently operating at full capacity and treating patients with conditions that are as complex as those. of the public sector. system.
Since the then government ended the state takeover of private hospitals for three months in late June, the HSE has been in negotiations with the independent hospital sector on a successor agreement to address any future spikes in Covid-19 cases. .
According to its latest proposals, the HSE does not seek to take over the full operational capacity of private hospitals.
Instead, as part of discussions with individual private hospitals, it is seeking an agreement that provides guaranteed access on a pre-agreed basis to 40 percent of typical levels of hospital and outpatient activity on a phased basis.
It is understood that HSE is seeking an “all inclusive” package of care to be provided under any new agreement, including physician services at the private hospital. This would be paid at the general rate. It would be up to the private hospital to make the necessary arrangements for such a comprehensive care package. The HSE does not anticipate having any direct contractual arrangements with individual medical consultants.
However, it is understood that the HSE wants any new agreement to stipulate the dispatch of some of its own clinical staff or other personnel to private hospitals to address a particular service requirement, and in such a scenario this would be reflected in the price you paid for the care package.
In such circumstances, the HSE would take care of the indemnity coverage for the physicians in question.
If a private hospital wanted to offer additional capacity to the HSE above the 40 percent maximum established in the proposals, this would be subject to a separate agreement.
It is understood that the proposals provide that when a public patient was treated as a private patient under a new agreement, any income received from a health insurance company with respect to the particular case would be offset against the bill paid by the HSE.
The private hospital would bill the patients who are responsible for the mandatory public hospital charges under the proposals and the revenues received would be offset by costs charged to the HSE.
The HSE has proposed that any new agreement with private hospitals have a duration of 24 months. However, there would be a review after a year that would look at developments related to the pandemic, including treatments or the availability of a Covid-19 vaccine.
After the midpoint review, a private hospital or HSE may terminate the arrangements with a one-month notice.
The HSE proposed that among the measures that would lead to a triggering of its proposals for private hospitals would be:
* National rate of Covid-19 infection in the community;
* national rates of hospitalization for Covid-19;
* national ICU occupancy levels;
* National acute hospital occupancy higher than 85%;
* pressure points of the emergency department of public hospitals.
There would be a maximum notice period of five days from the moment the agreement provisions were activated until the moment the HSE would have access to the private hospital capacity.
Members of the Association of Medical and Dental Consultants, a recently created new organization representing private sector medical specialists, expressed dissatisfaction with the HSE proposals late Thursday.
He said that although he would support measures in the national interest, the HSE proposals were poorly thought out. He said the HSE still didn’t fully understand how private hospitals functioned. He said that private hospitals were operating at full capacity today and that they were treating cases that were as complex as those in the public system.
Last weekend, Brian Fitzgerald, Beacon Hospital’s deputy executive director, told the Irsh Hospital Consultants Association annual conference that his board at the time was “unwilling” to sign a new agreement with the Government and HSE.
However, he said if there was a major crisis, hospitals like the Beacon would act and do what they could.
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