Response: Brian Lenihan, Minister of State at the Department of Health and Children, responds to points made by Maurice Neligan in his Heart Beat column last week, on the Government's plans to move 1,000 private beds in public hospitals in private facilities.
I'm grateful for the opportunity to respond to a number of points raised by Maurice Neligan in his column last week about the Tánaiste's plan to create 1,000 new public beds by moving existing private beds into new, privately managed hospitals.
Commenting on an article in The Irish Times by the Tánaiste, Ms Harney, Mr Neligan asks for details of the plan to be unveiled and debated in the Dáil.
The Tánaiste has published details of the plan announced at a press conference in July and on the Department of Health and Children website (www.dohc.ie).
The documentation includes a detailed letter from the secretary general of the department to the chairman of the Health Service Executive (HSE), which, in my view, clearly sets out the thinking behind the plan.
The aim is to create 1,000 new public beds in the most cost effective way. There are 2,500 private beds within our public and voluntary hospitals. Their capital cost is met by the State and their running cost is subsidised.
Moving 1,000 of these private beds into new facilities that are financed and managed by the private sector is based on the straightforward idea that the private sector should manage private beds and the public sector should manage public beds.
Each private bed moved will free up a new public bed.
By allowing private hospitals to be built adjacent to public hospitals, we can best ensure that public and private are complementary in patient services and in matters like medical training.
It is also an essential part of the Tánaiste's plan that public patients should have access to the private facilities.
When the new plan is implemented, the private facilities will not be closed to public patients. Instead, we anticipate arrangements whereby the public sector can purchase treatments as required in the new facilities for public patients, as the NTPF currently does.
The plan has been attacked by some as a privatisation of hospital services; by others, as undermining existing private hospitals. Both claims cannot be right. In my belief, both claims misunderstand the plan.
Creating new public bed capacity in public and voluntary hospitals can't be described as privatisation.
If public hospitals were being sold to the private sector or if the private sector was being asked to take over the running of public hospitals, I would agree that that was privatisation.
The plan, however, merely moves what are already private beds to privately run facilities to create more capacity for public patients.
Consultants currently earn fees from private beds in public hospitals; they will continue to earn fees from private beds in the adjacent private facilities. But the mix of public and private work will be more transparent and more capable of being managed properly and fairly.
The public-private mix is an issue that the HSE will be addressing in much needed talks with consultants on a revised contract and I would urge consultants' organisations to come to the table.
Mr Neligan queries the future for existing private hospitals. This plan will not undermine existing private hospitals.
The Independent Hospitals Association has welcomed the Tánaiste's plan. Our well-known private hospitals already operate in an environment where 2,500 private beds in public hospitals are publicly subsidised.
It has been Government policy for more than five years to level the playing field by moving to full economic charging for these beds.
This policy has been well known to all concerned. The new initiative will help to create that fully level playing field.
Indeed, the creation of new private hospitals is an opportunity for existing private hospitals since they are free to bid to run some of them.
In short, I would assure Mr Neligan and readers that the plan is fully thought through.
We welcome debate and discussion on it, because it is a substantial new initiative. We are confident it will serve the public interest.