Talks on public-only hospital consultant contract to restart next week

Talks on a new public-only contract for hospital consultants are expected to get under way again next week after a lengthy interruption.

Department of Health general secretary Robert Watt said he hoped the talks would restart next week and be concluded quickly if the Government and consultant representatives can reach agreement.

The negotiations broke down last year and then stalled completely when chairwoman, barrister Marguerite Bolger, was appointed to the High Court in December 2021.

Five months on, the Government has yet to appoint a successor.

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The contract is a central plank of Sláintecare health reforms aimed at moving private care out of public hospitals. Under draft proposals, it would offer a salary of up to €250,000 to consultants for public-only work.

Mr Watt told the Oireachtas health committee on Wednesday he hoped formal discussions with consultant representatives will restart next week.

The negotiations will conclude “very quickly, if we can” but this depended on the ability of those involved to reach agreement.

Asked about the decision by non-consultant hospital doctors to take industrial action over long working hours, Mr Watt said Minister for Health Stephen Donnelly will this week announce the establishment of a group to address the issues raised by NCHDs.

Progress so far this year in cutting waiting lists is slightly ahead of targets set in the Government’s action plan, Mr Watt told the committee, despite the impact of Covid-19.

The health service is also on target to provide 200,000 diagnostics through the community; 94,000 had been provided this year up to May.

Concerns

HSE director-general Paul Reid undertook to address Government concerns about the HSE’s plans to transfer the care of critically ill patients arriving at Navan hospital to other hospitals in the northeast. The HSE intends to “transition” the hospital’s emergency department by replacing it with a medical assessment unit. An average of six critically ill patients per day would be treated in other hospitals.

However, senior Government ministers, led by local Fine Gael TD Helen McEntee, have criticised the HSE’s plans and the manner in which it was announced.

Mr Reid said the changes have been prompted by very serious patient safety risks at Navan’s ED. It has no local governance, there is no acute surgical service in the hospital, the ICU is one of the smallest in the country and cover is provided by agency registrars, he pointed out.

“I have to take these risks very seriously. I can’t ignore them. We will address the Government’s concerns but we won’t compromise safety.”

Sinn Féin health spokesman David Cullinane said the public was concerned “the left hand doesn’t know what the right hand is doing” in terms of planning the changes. The resulting uncertainty was causing real concern in the area.

On accountability, Mr Reid said some disciplinary processes in place in the HSE date back to the 1970s and are not fit for purpose. He signalled changes in the way review of adverse incidents are carried out, so that the investigation into responsibility for the incident happens in parallel with the initial review, rather than after it.

While people had to be held accountable when things go wrong, the health service needs to create a culture where people feel safe to come forward, “not a gotcha culture”, he said.

Meanwhile, HSE national director Damien McCallion is to take up the position of chief operating officer when Anne O’Connor leaves for the VHI later this month. Mr McCallion will occupy the post on an interim basis pending a formal recruitment process at a later date.