Private practice in the health service

on title page "Report by the Comptroller and Auditor General"

Consultants employed within the publicly funded health service have the opportunity to work in the private sector. This report looks at the benefits provided by the 2004 contract and also points out areas for improvement. Part 1: Consultants and Private Practice; focuses on how the DHSSPS and the health service trusts in Northern Ireland have monitored and managed consultants to date. Most consultants are highly committed and work beyond their contractual obligations. But, prior to the introduction of the new contract in 2004, the quality of timetabled work programmes in the trusts was poor, and there was little monitoring of compliance by consultants. This led to a lack of clarity and accountability in the relationship between the public and private practice of consultants. The new contract is based on the overriding principle that a consultant's first and foremost commitment is to the health service patients, and provides the opportunity for the trusts to improve the management of consultants. Part 2: The Treatment of Private Patients in the Health Service examines how successful trusts have been in recovering the full cost of services provided to patients receiving private care within the Trust's facilities, a useful additional income stream. There is evidence of slow recovery of costs from private insurers, and a lack of basic debtor controls to gather money owed for treatment received, which is not compatible with good governance and accountability. NIAO feels there is an urgent need for some trusts to improve their cost recovery systems so that the full potential of income generation is realised and the needs of accountability satisfied.