RTÉ Investigates has found a failure by the HSE to properly implement the consultants' contract across acute public hospitals.
This has resulted in 14 out of 47 acute public hospitals having too much private practice, at the expense of public patients.
It is also leading to some HSE consultants working less than their contracted hours at public hospitals, because of private work commitments in private hospitals.
One such patient affected is 75-year-old Mary Comber from Limerick.
Mary is blind in one eye and has failing eyesight in the other and when she spoke to RTÉ Investigates she was facing a two-year wait for cataract surgery.
Mary Comber sold her jewellery to pay for cataract surgery pic.twitter.com/Xx4EBtpO6X— RTÉ News (@rtenews) November 21, 2017
Mary was among more than 1,200 public patients waiting for various procedures in the ophthalmology department in University Hospital Limerick.
As part of its research, RTÉ Investigates obtained what is known as Hospital Inpatient Enquiry (HIPE) data, which shows the breakdown of consultant’s private and public work.
This HIPE data is supposed to be used by management as part of a process to ensure that consultants stick to their private practice limits.
However, the data shows that the consultants in the ophthalmology department where Mary waited for surgery were not keeping to private practice limits.
The lack of controls placed on private work leaves patients such as Mary with hard choices. Either suffer and remain on a waiting list or find the money to go privately.
Last May, Mary got a train to Dublin, to sell all the jewellery she had accumulated during her life and managed to get enough money to afford to go privately.
Mary Comber: 'I brought all my jewellery ... it wasn't important any more.' pic.twitter.com/QNI9JdxJRD— RTÉ News (@rtenews) November 21, 2017
Mary found that by paying privately she could get her operation done at the same public hospital within two months instead of waiting two years as a public patient.
By paying almost €1,800, Mary had the procedure done at University Hospital Limerick within two months as a private patient.
RTÉ Investigates asked University Hospital Limerick chief executive Colette Cowan why a private patient can get faster access to the public hospital by paying to do so. She did not answer the question.
In a statement, Ms Cowan said the hospital group "has the lowest level of consultant cover in a number of specialities, including orthopaedics and ophthalmology" and that the UL Hospitals Group is "limited in theatre availability and bed capacity", both of which contribute to patient waiting times.
But, Mary Comber’s long wait to have full sight is not over. She is back on a public waiting list for cataract surgery on her left eye.