Public hospital consultants working longer in private practice than allowed


RTÉ investigation found consultant worked average of 20 hours private, 14.5 hours public

Consultants should work  a maximum of one day a week in private practice under the terms of their public service contracts. Consultants should work a maximum of one day a week in private practice under the terms of their public service contracts.




Public hospital consultants, who should be working a maximum of one day a week in private care, are working two to three times that amount, according to an investigation by RTÉ.

A programme that monitored three unidentified hospital consultants for eight weeks found they were working far fewer hours than contracted for in the public system.

A consultant with University Hospital Galway was found to work an average of 20 hours private and 14.5 hours public per week over the course of eight weeks. An orthopaedic surgeon was found to work 25 hours private and 23.5 hours public per week, while an ear, nose and throat surgeon was found to work 27 hours private and 18.5 hours public.

The consultants should have been working a maximum of one day a week in private practice under the terms of their public service contracts.

In fact, the consultants were being paid thousands of euro per week by the public system for work they did not do, according to the RTÉ Investigates programme.

It also meant public patients were waiting longer than would otherwise be the case, and contributed to a system where some public patients were eventually being treated in the private system by way of the publicly-funded national treatment purchase scheme.

The programme used information sourced under the Freedom of Information Act to show some hospitals were allowing their consultants breach the 20 per cent maximum for work in private practice.

While the national average was 19 per cent, consultants in Mercy Hospital, Cork, scored an average of 43 per cent, while those in St John’s Hospital, Limerick, scored an average 38 per cent. Mallow, South Infirmary and University Hospital Limerick scored, respectively, 35 per cent, 33 per cent, and 34 per cent.

The programme estimated an additional 43,500 patients were seen in the private system over a two-year period as a result of public hospital consultants breaching the terms of their contracts, the equivalent of one third of the public patient waiting list.

€1,800 for eye surgery

The programme interviewed Mary Comber (75), from Co Limerick, who had lost the sight in one eye and had failing sight in her other eye. She was on a two-year waiting list for eye surgery in University Hospital Limerick. Eventually, she paid €1,800 for an operation on one eye, in the same hospital, under the private system, having only had to wait for two months.

“I probably feel like a bit of a hypocrite but there isn’t anything else available to me,” she said of paying for the procedure. “I want my sight now.” She continues to wait for the second procedure under the public system.

The programme also interviewed Stephen Cussen who is awaiting a procedure in Croom Hospital, Co Limerick, where 53 per cent of the patients getting treatment get it through the private system.

The waiting list is six months for private patients, and three years for public patients. Mr Cussen said he only went out of his home once a week because of pain in his knees.

“It’s not the life I had planned,” he said. “My quality of life is nil.” He said he hopes to win the Lotto so he can pay for an operation on his knees.

While new public contracts for consultants introduced in 2007 were supposed to get consultants to do more work in public hospitals, the programme found only 6 per cent of the consultants in the public system did only public work.

It found 15 per cent of consultants were doing private work in private facilities that were off the public campus.

In 14 out of 47 hospitals, the amount of private work being done by the consultants exceeded the 20 per cent contractual limit.

The Director General of the HSE, Tony O’Brien, did not respond to a request for comment on the evidence that the terms of all consultants’ contracts were not being implemented.

The Irish Hospital Consultants Association, in a statement, said it can confidently state the overwhelming majority of consultants are working well beyond their contracted hours in an effort to provide care for patients in an under resourced health care system.

The association’s president, Dr Thomas Ryan, said each year, hospital consultants throughout the country treat a quarter of a million more patients compared with a decade ago, despite the fact hospitals now have 12 per cent fewer in-patient beds.