Health Minister calls for CHI report on consultant misuse of waiting list system to be published

THE HEALTH MINISTER has said she wants an internal investigation which found a consultant had breached guidelines by referring public patients to his own private clinic to be released in the “public interest”.

It follows reports that an internal investigation by Children’s Health Ireland (CHI) found that the consultant breached HSE guidelines with these referrals. 

The consultant was paid €35,800 via the National Treatment Purchase Fund (NTPF), which aims to cut waiting times by paying private practices to treat patients on public waiting lists.

While CHI said the “confidentiality of those who participated” in the internal investigation needs to be respected, Health Minister Jennifer Carroll MacNeill called for a redacted version of the report to be released in the public interest.

The Irish Times today reported that the consultant at the centre of the internal CHI investigation didn’t fulfil his on-call hours for more than three years due to health issues, yet went “above and beyond his contractual hours” to conduct weekend clinics.

The Irish Times reports that the consultation seen twice the number of patients in the weekend clinic than during his regular weekday equivalent, and received €35,800 for this weekend work.

Caroll MacNeill said these reports “suggests a very significant problem”.

She told RTÉ’s Morning Ireland that she wants “maximum productivity” in the public system and wants to “remove incentives that may create perversions of the kind that’s described there”.

She added: “I do not want to see a situation where there is less than full productivity in the public system and then private clinics picking that slack up when insourcing an NTPF model.

“I have a concern that that has led to some incentives to delay treatment, and that is why a number of weeks ago, we commissioned a full audit of that practice right across the board.

“Where we look at this report, that has not been published, my concern for that is the correct use of taxpayer’s money, but even more importantly, patient safety and patient outcomes for very young children who needed surgical intervention.”

‘Inaccurate reporting’

The internal CHI report in question was conducted at the end of 2021 and finalised in January 2022.

In a statement on Monday, CHI said the “recommendations have been implemented and are ongoing”.

However, the CHI statement said there has been “inaccurate media reporting in relation to NTPF payments to a Consultant”.

CHI said these clinics did not take place in the Consultant’s private rooms but “occurred in a public clinic, in one of its hospitals, on a Saturday”.

“The NTPF funded the hospital for this waiting list initiative and there was no charge to patients,” said CHI.

“This was over and above the Consultant’s contractual hours. There are no direct payments to CHI staff from NTPF.”

CHI added that it considered requests to publish the report and sought legal advice.

The statement said it is “primarily a HR report where the confidentiality of those who participated and fair procedures need to be respected given the sensitive nature of the report”.

NTPF funding

The NTPF aims to cut waiting times by paying private practices to treat patients on public waiting lists.

However, NTPF funding to CHI has been suspended and Carroll MacNeill said the NTPF has “looked for certain assurances from CHI, which I understand they’re in the process of receiving”.

Carroll MacNeill said she had been assured by the NTPF that the existing surgery scheduled will not be impacted by this.

The Health Minister added that she had a “very good meeting” with the Attorney General last week and she was informed that she does not have a “legal basis to publish the report” as it is the “property of CHI”.

“I do recognise some of the difficulties that CHI face in that this was a HR report where people contributed on a confidential basis and put themselves at risk in doing so,” said Carroll MacNeill.

“There’s a measure of management, because we do want people to contribute to other HR processes.

“Nevertheless, I think it’s important that a redacted version of this report is published in the broader public interest.

“It is important that people understand the broad issues that have happened here and what needs to happen next.”

Last month, HSE CEO Bernard Gloster said that the potential for CHI to be fully subsumed into the HSE will be one option considered amid concerns around clinical care and governance.

Carroll MacNeill today said this is a “separate, longer term public policy consideration”.

Meanwhile, three board members of CHI resigned last week, and Carroll MacNeill remarked that there has been “a significant refresh”.

“There are more board vacancies and I think the correct approach to this is to continue to appoint members of the HSE board to CHI board, insofar as that is possible.”

And while Carroll MacNeill called on CHI to release a redacted version of the report, she said she has “confidence” in its chair Lucy Nugent, who was appointed last November and took up the role in February.

Carroll MacNeill said Nugent “has begun a significant program of transformation in a couple of different ways”.

“A lot of these practices predate her, and I want to offer my support to the new CEO.”