Hospital consultants are working at “maximum capacity” and the new public-only contract “will not, in and of itself, solve the chronic problems the health service is facing”, the Irish Medical Organisation has said.
On Friday, The Irish Times reported concerns from the Health Service Executive (HSE) about whether hospitals and community healthcare organisations (CHOs) are “deriving the necessary benefits” from the new public-only consultant contract.
The contract, which seeks to remove private healthcare from the public system, also intends to enhance senior decision maker presence on-site, out of hours and at weekends.
However, earlier this month, Damien McCallion, chief operations officer at the HSE, wrote to the chief executives of hospitals and CHOs stating “weekend and extended day working arrangements” in the pre-agreed areas “needs to be demonstrated”.
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He said a national oversight group was established to oversee implementation of the contract had identified “a significant number of sites where no obvious benefits are being derived despite large numbers transitioning to the contract”.
In a statement on Friday, the IMO said it is “not realistic” to infer the health service will see “tangible benefits” if consultants are consistently rostered outside “‘normal’ working hours”.
The chronic deficit in hospital bed occupancy levels in particular was highly dangerous and was leading to serious overcrowding across the system
— Prof Sadlier
Professor Matthew Sadlier, chair of the Consultants’ Committee of the IMO, said if consultants are obliged to work odd hours, then clinics at other times will have to be cancelled as there is a significant lack of doctors to provide cover.
“There are hundreds of consultant posts that remain vacant or filled on a temporary basis, and the consultants in our system are working at maximum capacity. There is no room for manoeuvre unless major investment for more doctors and more beds, along with significant structural reform and realignment, are provided,” he said.
Prof Sadlier said consultants are not currently facilitated to provide optimal care to all patients “given our chronic shortage of beds, inadequate access to diagnostics and an unmanageable waiting list backlog”.
“The chronic deficit in hospital bed occupancy levels in particular was highly dangerous and was leading to serious overcrowding across the system,” Prof Sadlier added.
According to the most recent figures, almost half of the consultant workforce is now on the new public-only consultant contract, which was introduced in March last year, despite opposition from both the IMO and the Irish Hospital Consultants’ Association.
Under the contract, consultants can be asked to work 8am to 10pm from Monday to Friday and 8am to 6pm on Saturday as part of their core 37-hour week. Any private work they do has to take place outside their rostered hours, away from the public facility.
Basic pay under the contract ranges from €217,325 to €261,051 on a six-point scale, with additional pay for on-call duties and overtime, and supports for medical education training and research.
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