Consultants in Private Practice

As an IHCA member, you now have complimentary access to specialist consultancy services through HR Brief Limited, designed specifically to support Consultants in managing the complex employment, regulatory, and governance requirements of running a private medical practice.

Whether you are employing practice managers, nurses, administrative staff, or considering the implementation of new technologies in your practice, navigating employment law, data protection, health and safety compliance, and emerging AI regulations can be challenging. HR Brief’s dedicated team brings deep expertise across all these areas, providing practical, accessible guidance when you need it most. Their experience with the unique demands faced by medical consultants ensures that IHCA members can focus on patient care with confidence, knowing their practice operations are compliant and effectively managed.

The service is free of charge for IHCA members and includes expert advice on:

• Recruitment and contracts of employment
• Disciplinary and grievance procedures
• Workplace investigations
• Redundancy and dismissal processes
• Employment equality matters
• Data protection compliance, including GDPR requirements

In addition, HR Brief provide guidance on health and safety management, artificial intelligence implementation and compliance, and corporate governance matters.

To simplify compliance, members have access to a comprehensive suite of templates and policies ready for immediate implementation, including:

• Contracts of employment
• Disciplinary and grievance procedures
• Data protection policies
• Health and safety documentation

All templates and guidance are tailored specifically to the needs of medical practices, ensuring you have practical tools to manage your practice efficiently and confidently.

Points of Contact

For template contracts and employment policies, please contact Aidan O’Reilly, IHCA, by phone on (01) 298 9123 or by email to a.oreilly@ihca.ie

For all HR, Industrial Relations, Employment Law, Data Protection, AI Compliance, and Health & Safety queries, please contact HR Brief directly as per the details below and advise them that you are an IHCA member.

Mary Seery Kearney BL
Barrister specialising in Labour & Employment Law, Data Protection & Cyber Law
Mobile: 087 329 1306
Email: mary@hrbrief.ie 

David Kearney
HR, Industrial Relations & Data Protection Specialist
Mobile: 087 329 1300

Email: david@hrbrief.ie 

The helpline service is available by telephone and email during regular business hours (9:00 am to 5:00 pm, Monday to Friday, excluding public holidays).

Perfect Practice is a Practice Management Consultancy that offers advice and assistance to Consultants for the purpose of optimising their medical practice in terms of financial structure, efficiency, strategic planning, workforce and team development, patient experience, processes and marketing. As part of your IHCA membership, you have exclusive access to discounted rates and preferential treatment if you engage Perfect Practice to assist or provide advice to you on your practice arrangements. Please see details here.

Your IHCA membership provides you with exclusive access to a dedicated financial services panel designed to support the effective management, structuring, and growth of your private practice. The panel comprises suitably qualified firms and individual advisers with expertise across financial, business, and insurance domains, including:

• Incorporation of Medical Practices and Group Practices/Partnerships
• Accounting and Business Advisory Services
• Personal and Corporate Taxation
• Mortgages and Business Property Financing

For further details, please see here.

The Association regularly hosts CME webinars and events on issues of direct relevance to Consultants in private practice. Further events are planned to take place over the coming months on various issues and topics, including:

• Pensions Auto Enrolment
• Setting up in Private Practice
• Business Planning for Consultants
• HR Essentials: Hiring and Employment Pitfalls
• Financial Literacy: Taxation, Pensions, Standard Fund Threshold, Wealth Management, and Investment Basics
• Navigating Conflict & Contentious Issues: Strategies for managing difficult conversations, ethical dilemmas, and interpersonal challenges in clinical settings

These events are offered free of charge as part of your IHCA membership.

Expert Witness Training

The Association recently announced its collaboration with The Expert Witness Site to provide our members with access to expert witness training and professional development opportunities. Our recent Expert Witness Training Webinars were well attended and enthusiastically received. You can view a recording of the Webinar on the IHCA’s video channel here.

The Expert Witness Site is an Irish organisation founded by barristers who source expert witnesses for legal teams and they are offering further bespoke, discounted training for IHCA members at King’s Inns, designed to give participants a clear understanding of what acting as an Expert Witness entails. The first of these workshops will be held on 25th November 2025 (for new Experts) and 26th November 2025 (for experienced Experts). Please see details of upcoming training sessions for IHCA members here or visit www.expertwitnesssite.com. This progressive partnership is the start of a forward-thinking strategy whereby the Association will develop a panel of Expert Witnesses from our membership to ensure that the highest standards of independence and excellence in expert evidence are upheld.

General Advice

We offer general advice regarding issues that arise in the context of medicolegal work, but we do not provide any advice or recommendations on fee levels as we are subject to certain restrictions under competition law. The fee charged in this regard is a matter for each individual Consultant to be determined at their discretion. However, we do advise members to respond to requests for medicolegal opinions by using a pro-forma letter (accessible here).

Clinical indemnity cover for medico-legal work

All consultants require clinical indemnity cover for medicolegal work undertaken for persons who are not patients or former patients. This may be particularly relevant for you if now retired.  Indemnity is required even where the work is undertaken on a public hospital site.

Attendance in Court and service of Subpoenas

We advise members to provide advance notice of their fee arrangements in medicolegal matters to relevant parties if requested to go on standby to attend in court (see here for pro forma letter referenced above, in PDF and Word).

Application of VAT

Our understanding is that non-medical services, such as the provision of medico-legal reports and fees for standby or attendance in court, are liable to VAT. VAT is charged on medico-legal reports at the standard rate of tax of 23%.  The full list of taxable medical services is available in Revenue’s Tax and Duty Manual here. Certain reports specified in Schedule 1 of the VAT Acts are exempt from VAT (e.g. Examinations for RTA, Gardaí). However, medicolegal reports are specifically included in Appendix 2 of the manual under “List of Taxable Medical Services”. Revenue requires that where income from such services exceeds €37,500 p.a., then the Consultant should register with Revenue here.

Finally, please note that while the Association can provide general guidance and information, we are not licensed or regulated to provide specific financial or taxation advice, in which case it may be necessary for some members to obtain independent advice from a suitably qualified adviser, depending on the specific circumstances that apply. As part of your IHCA membership, you have exclusive member-only access to a financial services panel that can assist you in this regard. The panel is comprised of suitably qualified firms and individual advisers across financial, business and insurance domains. See details here.

The Association has formulated a comprehensive GDPR and data protection guidance document for members in private practice, which comprises:

• An overview of the legal basis for processing by Consultants
• A series of practical action points
• Frequently asked questions
• A suite of template policies and procedures

Please note that all of the template policies and procedures are available in MS Word format so that you can amend and adapt them as necessary. Select here to download the IHCA's GDPR Guideline and Action Points for Hospital Consultants. Members also have complimentary access to specialist consultancy services through HR Brief Limited, which can assist with any GDPR or data protection queries. Please see details in the drop down list above (1. Free HR and Employment Support).

The Association provides guidance on the range of providers in the market and key considerations, such as the difference between ‘claims made’ and ‘occurrence-based’ cover. A detailed briefing document is available for download here. We maintain direct contact with all major indemnifiers and insurers and can liaise on your behalf regarding any questions or issues.

Our executive team is available to provide assistance and general guidance in relation to your engagement with private hospitals or clinics, including matters concerning contracts, practice rights, or admitting privileges that may be offered to you. Queries can be submitted for our attention using the online form here.

If you require legal advice on any specific aspect of your arrangements, you will be referred to the Association’s panel of legal firms. These firms have extensive experience and a strong understanding of the practice arrangements of Consultants, whether practising part-time or full-time in the private sector. Further details are available here.

Claims Processing

The Association holds regular meetings with health insurers in relation to claims processing, payment and monitoring issues. If you are experiencing any difficulties in this regard, we encourage you to contact the Association for support. In particular, members are requested to submit details and examples of claims queries and correspondence from insurers that are delaying payment of claims. When sending claims documentation, members are requested to ensure that any details likely to identify individual patients are redacted. It is useful however to leave claim numbers and policy numbers intact.

Schedule of Benefits for Professional Fees

The Association holds regular meetings with senior management in VHI, Laya Healthcare and Irish Life Health on their respective Schedules of Benefits for Professional Fees. A large number of meetings for speciality groups are conducted every year for the purpose of discussing issues related to new procedure codes, changes to existing descriptions, clinical indications, payment conditions, etc., within the confines of competition legislation restrictions.

Consultant Participation
Under competition law, an “undertaking” is defined as “a person being an individual, a body corporate or an unincorporated body of persons engaged for gain in … the provision of a service”. An individual Consultant providing clinical services in his or her own right is considered to be an undertaking or a single entity for competition law purposes. Consultants operating as a part of a group practice/partnership that is registered with a health insurer should note that the group practice/partnership is considered to be a single entity for competition law purposes. It is a matter for each entity to respond to the terms on offer from health insurers. In this regard, there are three broad options available as follows. It is important to note that entities must not engage in forms of coordinated behaviour or concerted practices in responding to the terms on offer from any health insurer.
 
Option 1: Accept the Participating Benefit
An entity, whether in the form of an individual Consultant or a Group Practice/Partnership, that signs a participation agreement with an insurer receives the Participating Benefit specified in the Schedule of Benefits and is not permitted to ‘balance bill’, i.e. charge the patient a fee in addition to the participating benefit specified for the particular procedure or service in the insurer’s Schedule. This is known as participating in the ‘Full Cover Scheme’ in that the patient has full cover from the insurer for fees arising from the inpatient or day-case treatment he or she receives and may not be billed any additional fee for that treatment.
 
Option 2: Accept the non-participating Standard Benefit
An entity, whether in the form of an individual Consultant or a Group Practice/Partnership, that decides not to sign a participation agreement with an insurer receives a lesser non-participating or standard benefit for the relevant inpatient or day-case treatment as specified for the particular procedure or service in the Schedule but is permitted to balance bill the patient for an additional amount over and above the standard benefit.

Option 3: Accept neither the Participating nor the Standard Benefit and bill the patient an agreed fee
An entity, whether in the form of an individual Consultant or a Group Practice/Partnership, is at liberty to disengage entirely from any insurer and advise patients that they accept neither the Participating Benefit nor the Standard Benefit from that insurer. The entity may elect instead to charge the patient at a fee rate to be determined between the parties.