Health service management has proposed that existing medical consultants who opt for a revised contract would in some cases be able to devote up to 30 per cent of their total workload to fee-paying patients in public or co-located private hospitals.
The proposal, which would effectively increase the level of private practice work permitted, is being signalled as management's final position in the current talks process. At present, 20 per cent is the maximum level of private practice allowed.
However, consultant organisations and management still appear to be far from concluding a deal, with major disagreements outstanding on issues such as the rights of doctors to advocate publicly on behalf of patients, clinical independence and rostering as well as private practice rights.
The Cabinet is expected to consider the issue tomorrow. A spokesman for Minister for Health Mary Harney said tomorrow's deadline for agreement still stood.
The Government is believed to have contingency plans to advertise the first of up to 1,500 new consultant posts on revised terms if a deal with medical bodies is not reached.
In talks last Friday, management proposed that "transitional" private practice rights should apply to existing consultants who opted for a new contract.
It proposed that existing consultants could engage in private practice in public hospitals and in the planned new co-located private facilities at the same level as in 2006, subject to an upper limit of 30 per cent of their total clinical workload.
Consultants with existing category II contracts, which allow them to see fee-paying patients in an off-site private hospitals, could continue to do so.
Management has insisted that these arrangements would be "red circled" and would only apply to existing consultants. No new staff would be able to work in off-site private hospitals.
The new contract would oblige existing consultants to work in teams and be available over an extended working day.
It is expected that the Government will ask talks chairman Mark Connaughton SC to provide a report on the process before tomorrow's Cabinet meeting. Mr Connaughton is expected to meet the parties individually in the morning in an attempt to draw together the areas of agreement. A full plenary hearing of the talks is scheduled for the afternoon.
The national council of the Irish Hospital Consultants Association has agreed to hold an extraordinary general meeting on April 22nd. Secretary general Finbarr Fitzpatrick said it opposed to management plans to restrict the rights to consultants to advocate on behalf of patients or to make doctors' clinical judgment conform to "corporate standards".
