Hospitals free to alter consultant practices

The Health Service Executive has said hospitals can introduce new work practices for hospital consultants from today if they are considered necessary.

However, it still remains unclear whether consultants will co-operate with the changes, which emerged from talks at the Labour Relations Commission in September.

Separately, a Labour Court recommendation on other issues involving consultants – rest days and payments to psychiatrists for second opinions – which had been referred by management under the Croke Park agreement, is expected as early as today.

The Irish Hospital Consultants Association (IHCA) refused to attend the Labour Court hearing on grounds that the measures referred by management fell outside the scope of the Croke Park deal.

Health service management and a second organisation representing hospital consultants, the Irish Medical Organisation (IMO), attended the Labour Court hearing.

Minister for Health James Reilly said last month that if hospital consultants did not co-operate with a Labour Court recommendation, they could find themselves outside the protection of the Croke Park deal. This could lead to pay cuts for serving consultants.

There has been speculation in Government circles that Ministers could also revisit the arrangement under which the IHCA is allowed to represent members. The association has exempted body status under trade union law, meaning it does not need a negotiating licence to carry out collective bargaining about pay and employment conditions.

The Department of Health says “there are no plans at present to review the status granted to the IHCA under the Trade Union Act, 1941”.

The changes in work practices involve introducing what management has described as “demonstrable changes in consultants’ attendance patterns, clinical and non-clinical work practices and reporting relationships”.

Roster

The changes provide significantly increased powers to clinical directors to roster consultants to maximise patient throughput and increase the presence of senior clinicians in hospitals across the day.

Some consultants will continue to work Monday to Friday, across a day running from 8am-8pm. Others will be rostered on any five of seven days, including weekends (although on the basis of only one weekend in five).

For the first time, consultants in areas such as emergency medicine, intensive care, neonatology and obstetrics will be rostered on a 24-hour basis, working eight-hour shifts. Dr Reilly has said the proposals could save up €200 million.

However, the IMO has yet to ballot its members on the changes. The IHCA said it could not engage in collective bargaining and that it would be up to individual members to accept changes to their contractual arrangements.