The Government is to press ahead with the new contract for hospital consultants, which will see extended hours in the evenings and at weekends, despite not having yet the agreement of the doctors’ organisations.
Minister for Health Stephen Donnelly intends to signal the commencement of the new contract in early to mid-February, he has told colleagues. From then on, it will be the only contract offered to new consultants, while existing consultants will have the choice of switching to the new contract if they wish.
The contract was finalised in December after lengthy negotiations, after which the Government agreed to give medical organisations two months to consult their members.
Health authorities hope the new contract will unlock the appointment of hundreds of new consultants to fill posts currently vacant in hospitals across the country. In addition, the extended working hours covered by the new contract will enable greater rostering of consultants in the evenings and at weekends, which it is hoped will ease overcrowding by facilitating more efficient discharges of patients.
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Doctors’ organisations said they had not yet agreed to the new contract and have warned Mr Donnelly not to proceed without their agreement.
The Irish Medical Organisation said it had sought clarification on a number of issues from the Department of Health and had told the department it would indicate its attitude to the new contract at the end of this month. “Given the commitment of the IMO and its members to the negotiations and allowing time for clarifications, we expect that the Department of Health will respect that the process has not concluded and will not offer out the proposed new contract in advance of our response,” the organisation said.
The Irish Hospital Consultants Association (IHCA) said it was also continuing to consult its members. “There remain a number of important issues that need to be addressed to ensure any proposed contract will reduce patient waiting times and address the consultant recruitment and retention crisis,” it said in a statement.
The contract offers doctors salaries of up to €252,000. However, with additional allowances and payments for on-call duties and overtime, as well as pension contributions, many consultants will receive a package worth as much as €300,000 a year. Doctors who choose to move from their current contract will remain on the existing public sector pension scheme. Doctors who have already received job offers can choose to take the old contract.
The new contract will prohibit consultants from engaging in private work in public hospitals, considered a key tool in the separation of public from private care – one of the objectives of the Sláintecare health reform plan to which the Government, and all Opposition parties, say they are committed. Sláintecare envisages that over time all private practice will be removed from public hospitals, leaving a public-only healthcare system in publicly owned hospitals.
However, once they have completed their 37-hour week, consultants employed under the new contract will still be entitled to pursue private work in other locations, for example, in private hospitals adjacent to public facilities.
Health chiefs hope the new contracts will allow much greater flexibility in rostering consultants, enabling them to provide a greater coverage of consultant care in evenings and especially at weekends. It is hoped this will result in a more even flow of patients being discharged, avoiding the situation currently experienced in many hospitals where discharges slow at weekends because consultants are not on site to authorise them, leading to a logjam of patients in emergency wards awaiting beds.
Last weekend, in response to a request from Mr Donnelly and the HSE, many consultants worked, leading to a sharp drop in the number of patients waiting on trolleys. Health chiefs hope that rostering consultants under the new contract will achieve this on a routine basis.
The new contract will see consultants rostered for hours between 8am-10pm Monday-Friday and 8am-6pm on Saturdays. Any work outside these hours will be subject to local agreement and involve overtime or special payments.
