The Rotunda hospital has doubled down on its defiance of a Government order to stop public-only consultants treating private patients in a challenge to public health policy.
The board of the biggest and busiest maternity hospital in the country held an extraordinary general meeting on Friday, where the governing power declined to back down from its decision to allow public-only consultants continue offering private care on-site.
It came after Minister for Health Jennifer Carroll MacNeill cast doubt on the Rotunda’s clinical indemnity insurance – the crucial State-funded legal protection without which a maternity hospital could not afford to operate. Carroll MacNeill also suggested the maternity hospital could owe refunds to women who received private care from consultants who were on public-only contracts.
The number of consultant obstetricians on public-only contracts at the Rotunda is small, with just one doctor delivering two private patient babies under this model between January and March of this year. But it is understood the Rotunda is defying the Government on a point of principle, as part of its fight to try to keep private maternity care in publicly funded hospitals.
RM Block
Two out of three of the Dublin maternity hospitals have now sought an exemption from Sláintecare, the policy designed to remove private practice from public hospitals, after the National Maternity Hospital said on Friday that it also wanted a “derogation” for its consultants from public-only contracts.
The Rotunda has been given until Monday to share a detailed audit with the Health Service Executive of the private work carried out by public-only consultants at the hospital, including how much money the Dublin maternity hospital has made from such care.
It is understood that in a brief letter to Carroll MacNeill on Friday, the board of the Rotunda advised that it was planning to co-operate with the HSE’s request for information.
At the meeting on Friday, it is understood that the board was critical of what it felt were threats being issued against the hospital via the media. The HSE has already said it may trigger a process under its contract with the Rotunda that could result in the maternity hospital’s funding being withheld or withdrawn.
Carroll MacNeill said she expects “compliance” from the hospital, which both the Government and the HSE say does not have the authority to give public-only consultants permission to offer private care. But the Rotunda board has now sought a meeting with the Minister to “explain the rationale and impact” of its decision to allow doctors who signed public-only contracts to continue offering private care.
The board decided as far back as September 2024 that it would be giving its consultants permission to go against the public-only nature of their new contracts, which came into effect in December 2025.
“In all of its deliberations, the Board’s overriding priority is to ensure that every patient receives the best possible care, regardless of whether they are a public or private service user,” it noted in a statement.
“The Board has written directly to the Minister for Health ... to seek a way forward to resolve this issue for the common good of all patients.”
The Department of Health has not yet responded to the Rotunda.
Carroll MacNeill said she felt it was “egregious” that “instead of putting the resources into making sure that all women are getting the same care, led and with a consultant on site in the way that they’re capable of being rostered”, the Rotunda was proceeding with a plan to only have certain consultants on call for private women.
One big insurer has already confirmed that it will not be processing claims from public-only consultants at the Rotunda who are offering private care.
A VHI spokeswoman said the insurer “will not process claims for private activity in a public hospital where consultants hold public hospital-only contracts”. Laya Healthcare also said that “where a consultant has entered into a public-only contract, we would not expect private fees to arise”.
Irish Life referred the Irish Times to a comment from Insurance Ireland. Inrusance Ireland said its members were “adhering to the policy intention of implementing the Public Only Consultant Contract (POCC) and taking guidance from the Department of Health in respect of this. Where a Consultant has entered into a public-only contract, we would not expect private fees to arise.”
