The 1989 Report of the Commission on Health Funding and the Department of Health, their ultimate employer, disagree.
Consultants insist they are committed to public patients.
Consultants receive salaries for their public commitments and individual fees for seeing private patients. On the issue of the role of private practice in perpetuating the two-tier system, the Government White Paper on private health insurance describes the growth of private medicine as a potential threat to public patients' access to the services of the public hospital system. The Government has attempted to ensure equal access for public patients to public hospitals by limiting the number of private beds. The ESRI report suggests that, while there is no evidence of consultants using public beds for elective admissions for private patients, present monitoring systems are inadequate. An alternative way to promote equity of access, it says, would be to pay consultants private fees only when their patients are in private beds.