Removing private care from public hospitals would be a complex process, that would take many years to complete and cost billions of euro, a new report has found

The findings are contained in the Report of the Independent Review Group, which was established to examine private activity in public hospitals.

The group was established by the Minister for Health, Simon Harris, following on from a proposal contained in the 2017 Sláintecare Report that private care should be phased out in public hospitals.

The Sláintecare Report 2017 is a 10-year plan aimed at reforming healthcare in Ireland.

The Report of the Independent Review Group found that the current public hospital system experiences "very high demand" and existing capacity is not sufficient to meet this demand.

However, it noted that removal of private activity "is unlikely to generate significant additional capacity in the short-term", as a lot of activity will remain in public hospitals, such as Emergency Department-related services and maternity services.

The report also found that public hospitals are reliant on the income from private activity (€524 million in 2018), even though allowing private activity "uses considerable public resources to the advantage of those patients who can afford to pay privately rather than public patients".

Meanwhile, the report also noted that just 6% of consultants are currently engaged on public-only contracts and contracts with private practice rights "have not been managed as well as they should have been".

The group makes a number of recommendations about how to proceed, including:
-Introducing legislation to ensure that public hospitals are exclusively used for the treatment of public patients from the conclusion of the 10-year Sláintecare implementation period
-All new consultant appointments should be to a Sláintecare Consultant Contract, which allows only public activity in public hospitals
-Pay to consultants should be restored to pre-2012 levels for all existing consultant contracts and new entrant Sláintecare Consultants Contracts.

However, these changes would take up to a decade to implement and cost over €600 million per year, a total of more than €6 billion.

It would also mean potential changes to the health insurance market. For example, in the longer term, it is likely that the number of people availing of private insurance will fall because they will no longer be able to opt for private care in public hospitals.

Around 800,000 people, or 40% of the current private health insurance market, receive their private treatments and benefits in public hospitals.

"These are the people most likely to reconsider the need for health insurance, especially if public hospitals are seen to be delivering timely, quality healthcare," the report noted.

The findings were welcomed by Minister Harris, however he warned that removing private care from public hospitals "is complex, would take time and would cost money".

"Developing a single-tier public hospital system is one of the fundamental reforms envisaged in Sláintecare and decisions on expenditure including on the issues raised in the report must be made in the context of the wider implementation of Sláintecare and the Public Service Stability Agreement 2018-2020.

"I intend to consult with key stakeholders and my colleagues in Government to consider further key implementation issues and return to Government in due course," he said.

The report can be viewed here.