Consultants ‘too slow’ as hospitals wait for Û12m in insurance money

Date Published: {J}

BY CIARAN TIERNEY

Delays by consultants in ‘signing off’ claims against private health insurers are costing Galway city’s two public hospitals up to €12 million at a time they are under severe financial pressure.

It emerged this week that University Hospital Galway (UHG) and Merlin Park hospitals are owed €12m from private insurance companies such as the VHI, Aviva, and Bupa, much of it because highly-paid consultants are slow to process claims on behalf of the hospitals.

The Chairperson of the HSE Regional Forum (West), Cllr Padraig Conneely (FG), has described the delays in processing the claims as “financial negligence” and called for sanctions against specialists who are slow to do so within a specified time frame.

“At a time when Galway University Hospitals [UHG and Merlin Park] are financially cash starved, it is beyond belief that the West of Ireland’s major acute hospital is owed €12 million from private insurance companies,” said Cllr Conneely.

Cllr Conneely received confirmation of the money owed from the Health Service Executive (West) this week after raising the issue at a recent hospital committee meeting.

Given that on occasions dozens of patients have been forced to sleep on trolleys at UHG overnight, Cllr Conneely said it was astounding that some consultants were slow to process delays on behalf of the hospitals despite having no qualms about making claims on their own behalf.

“It is all down to the slowness of, and administrative problems with, some consultants,” Cllr Conneely told The Connacht Tribune. “Last year we had major financial problems and cut-backs across UHG. And yet there is €12 million available for work done if this problem could be sorted out between management and some consultants.

“Those consultants have the use of private beds in public hospitals and I think they are being very unfair. Their tardiness in ‘signing off’ on health insurance claims is leaving the hospitals with over-stretched finances.”

He called for sanctions to be introduced for consultants who fail to process claims on behalf of UHG within a specified time period such as 30 days. “It’s the public hospital system that’s paying the price, by being millions over budget,” he said.

Cllr Conneely said the consultants were able to treat private patients in Galway’s two public hospitals and management could then recoup costs from the health insurance companies.

But, before the hospital can make a claim, the consultants must ‘sign off’ on the relevant documentation. Cllr Conneely claimed that some consultants went weeks or even months without completing the documentation, despite making their own personal claims to the health insurers.

“There must be major changes in the way UHG does its business,” said Cllr Conneely. “Old working practices of consultants need to be urgently reviewed by management. This €12 million ‘black hole’ in the budget must be addressed.”