Hospital specialists to oppose change in contracts

The secretary-general of the Hospital Consultants' Association has confidently predicted that his members will block implementation…

The secretary-general of the Hospital Consultants' Association has confidently predicted that his members will block implementation of controversial Government plans to force newly appointed consultants to work on salaries and exclusively for the public service.

The Department of Health says the new contracts are essential as part of plans to reform hospital care and to circumvent current practices which mean many public patients are treated by unqualified junior doctors or registrars.

Under the terms of existing contracts, hospital consultants in publicly salaried posts are allowed to conduct private practice in public hospitals, even in their publicly salaried hours.

They can also absent themselves from their employing hospital to work in private hospitals.

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However, the Minister for Health announced in the 2001 Health Strategy that the Government was going to forge ahead with plans for a public-only, salaried contract. The plan has yet yet to be pursued in contract negotiations.

Mr Finbarr Fitzpatrick has said his members will use all their influence to make sure nobody takes the new contracts, and that the new system does not become a reality.

Documents newly released by the Department of Health under the Freedom of Information Act make clear the extent of the Department's dissatisfaction with the current contract.

An internal working group concluded that "changes to the current Common Contract are critical to improvement in the current equity situation".

The group said the current contract did not stipulate that consultants must work "solely for public patients" in their salaried hours.

Another working group deplored the practical consequence of this lax arrangement:

"Within this 33-hour commitment, they may practise privately (varying between on-site and off-site depending on category) subject to meeting commitments to the public hospital and to the ratio of public-private beds in the hospital."

It added: "This provision must be changed so that the needs of public patients are fully met and that consultants are no longer effectively paid twice for 'private' hours worked within the 33-hour commitment."

Although Mr Fitzpatrick accepted that the Minister for Health had the power to introduce this contract for new appointees who would not be "in a good negotiating position", he added: "If he wants to get the agreement of the IHCA, I can tell you now that he won't."

In an interview in a forthcoming book on the Irish health system, Unhealthy State, Mr Fitzpatrick said that, while the IHCA would never strike, it would use all of its influence to make sure nobody took the proposed new contract.

Although the health strategy recognised that existing consultants had a contractual right to carry out private practice in public hospitals, it made clear that the Department of Health wished to renegotiate the terms of the contract to deliver better care for public patients, who are frequently treated by junior doctors.

"Greater equity for public patients will be sought in a revised contract for hospital consultants", the strategy stated.

"It will be proposed that newly-appointed consultants would work exclusively for public patients for a specified number of years.

" This would mean that consultants would concentrate on treating public patients in the early years of their contract, but would be in a position to develop private practice at a later stage where their contract so permits."