HSE may face consultants' confidence motion

Hospital consultants are to consider a motion of no confidence in the Health Service Executive (HSE) at a special conference next month.

The national council of the Irish Hospital Consultants' Association (IHCA) decided at the weekend to convene an extraordinary general meeting of members on January 28th to reflect what it described as the growing frustration of senior doctors at how the health service was being managed. IHCA secretary general Finbarr Fitzpatrick said yesterday that consultants believed it was now virtually impossible to have decisions made locally by health service management.

He said responsibility for decision making was being passed on from one level in the HSE to the next until it reached the headquarters in Parkgate Street in Dublin. He also maintained that there had been no streamlining of management following the abolition of the health board system and the establishment of the centralised HSE.

Mr Fitzpatrick said there was unhappiness among doctors at regular cancellations of elective or non-urgent admissions to hospitals. He added that consultants believed such procedures were being cancelled to allow hospitals to concentrate on dealing with overcrowding in accident and emergency departments. "The trolley count now comes before all else," he said.

The Irish Times revealed last month that more than 90 per cent of people treated as inpatients in a number of acute hospitals in the first half of the year had been admitted as emergency cases.

A HSE report found that in two of Dublin's main hospitals, St James's and Tallaght, around 80 per cent of patients discharged in the first six months of the year had been admitted through the A&E departments.

Mr Fitzpatrick also said that there was unhappiness among consultants at the comments made by the Minister of State at the Department of Health Tim O'Malley regarding responsibility for waiting lists for child psychiatry services.

Relations between hospital consultants and health service management have deteriorated in recent months, particularly after a unilateral decision by the board of the HSE to abolish a type of contract that allowed consultants to treat fee-paying patients in private hospitals.

This issue has led to talks on a new contract for hospital consultants reaching the brink of collapse.

The independent chairman of the talks process has told the parties in the last 10 days that there is no point in continuing discussions in their current form if they adhered to their current rigid positions.

In a confidential letter sent to doctors' representatives and health service management, senior counsel Mark Connaughton said that he was not satisfied that either side was blameless for the current impasse.

Mr Fitzpatrick said yesterday that while the row over the contract talks had generated anger among consultants, it was by no means the main reason for the decision to consider a motion of no confidence in the HSE.

The HSE has also been criticised in recent weeks by politicians in Leinster House over delays in answering parliamentary questions tabled by deputies.

It emerged in recent weeks that around 10 per cent of parliamentary questions referred by Minister for Health Mary Harney to the HSE since the start of the year have still not been answered.