Private Patient Income: Health and Social Services Department

Background

Clinical consultants working in the Health and Social Services Department (HSSD) are permitted to undertake work for privately funded patients if they fulfil their contracted hours for publicly funded work.

Private patient services which need an operating theatre are undertaken at HSSD’s General Hospital. For these and other private patient procedures that use HSSD facilities and resources, HSSD makes a charge.

Scope

This review considers the extent to which:

• HSSD has established and articulated policies and procedures for private patient activity and income that are consistent with other policy objectives
• there are adequate arrangements to establish charges for private patient activity
• there are adequate arrangements to identify private patient activity and bill patients or insurers
• there are adequate arrangements to recover private patient income promptly
• there are appropriate arrangements for establishing the budget for private patient income and monitoring performance against budget
• private patient income is appropriately reflected in longer term planning; and
• there are adequate arrangements for monitoring compliance with operational policies and procedures, including the contractual conditions of consultants for undertaking private patient work.

Conclusions

There is good practice in relation to budget setting for this area and effective management of private patient income once billed. However, much needs to be done to ensure the private patient activity is well managed, costs fully recovered and to be able to demonstrate that the activity does not detract from public provision.

Work needs to be completed on the integration of longer term planning in this area with other planning within HSSD. Steps also need to be taken to address time consuming and potentially ineffective systems.

This report echoes some of findings from earlier reports, particularly the weaknesses in policies and procedures to secure and use high quality information. It is important for decisions to be based on good information and this should be a priority for HSSD and the States more widely.