More than 700 hospital consultants have signed new public-only contracts that will involve them working extended hours during evenings and weekends, new figures show.
The new contract, which was introduced last March, is the only one available and prohibits those that sign from engaging in private work in public hospitals.
It offers salaries of up to €252,000, with packages of up to €300,000 with additional allowances, on-call and overtime payments and pension contributions.
The Department of Health confirmed that 737 consultants had signed up as of last Wednesday, an increase of 319 since the end of last month.
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A breakdown of the 418 sign-ups recorded by the end of August showed 293 were existing consultants, while 125 were new appointments.
President of the Irish Hospital Consultants Association (IHCA) Prof Rob Landers acknowledged the increase but said the rate of sign-ups is “desperately slow compared to that of the previous contract”.
Speaking to The Irish Times at the association’s annual conference in Dublin on Saturday, Prof Rob Landers said that while there is “some take-up” there are “clearly some problems” with the contract.
The IHCA, whose 3,650 members is estimated to represent about 95 per cent of Irish consultants, believes adjustments to “some aspects” of the contract would lead to more doctors agreeing to it, he said.
“Perhaps this can be revisited,” said Prof Landers, adding that he does not mean the entire contract should be renegotiated.
Members are nervous about signing up as the contract makes provision to move consultants around the country and also does not limit the number of weekend or late night shifts they might be asked to cover, he said.
“We were looking for reassurance on those points, which was not forthcoming. Consultants will be slow to sign a contract where they may be asked to move location or to do an undue number of weekend or late shifts. That is not the case anywhere else in the developed world,” he said.
The conference was told the Minister for Health was invited to attend but was not available.
Speaking at the IHCA conference, Sinn Féin leader Mary Lou McDonald said she would not retract the consultants’ contract if her party was in Government.
She would rather consultants embrace the contract as agreed, which took a lot of time and is her preferred contract.
“I believe in a public system that is properly resourced and funded. I believe in public medicine,” she said.
There would still be a role for private providers under a Sinn Féin universal healthcare system modelled on the UK’s National Health Service (NHS), she stressed.
Her party has promised to deliver an “Irish NHS” within two terms of being in Government. She does not dream about relocating the NHS offering currently available in Northern Ireland, which she said is the victim of actions by the British Conservative party.
Sinn Féin envisages a move to a “seven-day” health service that is a technological leader. Mental health treatment and disability healthcare would move from the sidelines to the centre, she added.
It is “essential” that changes are led by experience and data.
Asked about the IHCA’s view on Sinn Féin’s proposals, Mr Landers said the party’s health policies are “reasonably closely aligned with our own”.
The association has not heard “anything to cause alarm” from Sinn Féin and feels their proposals are “quite good”.
“Their aspirations for a proper health service and a good hospital service are very closely aligned with our own ... It is a matter of funding it and implementing them if they did get into power,” he said.
He echoed Ms McDonald’s criticisms of “inertia” at the centre of the healthcare system and the difficulties of getting capital programmes over the line.
“A lot needs to happen and I know Sinn Féin talks about doing this over two terms in Government. It is going to take at least that ... This can be done but it takes commitment on all sides,” he added.
Labour leader Ivana Bacik told the consultants her party’s top priority for health is to roll out free GP care.
There is no shortage of healthcare commitments from the Government, but there is a lack of detail on how those commitments will be delivered on, she said.
There should be a reassessment of the National Development Plan to ensure there is enough funding for healthcare infrastructure plans for the next five years. Labour does not want to see further delays and tenders being paused, she added.
Ms Bacik said her party is also concerned by a “growing reliance” on outsourcing services from private providers. Such a “short-term” solution is to the detriment of the overall health system as it “undermines the case for investing in our public service” and increases competition for staff, she said.
Members who attended the IHCA conference on Saturday unanimously voted to call for the Government to commit €4 billion in capital funding in October’s budget to build and open hospital beds, theatres, diagnostics and other facilities already announced by the Minister for Health.
They also agreed the Government must address the issue of 933 consultancy posts that are vacant or filled only on a temporary basis.
