The Government’s new public-only contract for hospital consultants comes into force on Wednesday, despite its rejection by two medical representative bodies.
From then, the new contract, which offers a salary of up to €257,000 a year, will be the only one offered to new consultants, consultants who wish to transition from existing contracts or consultants changing employers.
Uptake is uncertain following its rejection by a majority of members balloted by the Irish Medical Organisation (IMO) and most of those who responded to a survey conducted by the Irish Hospital Consultants’ Association (IHCA). The Department of Health said it remained confident that there would be “strong uptake” of the contract by new and existing consultants.
Fifty-seven per cent of current IMO consultants said they would not switch to the new contract, 64 per cent of junior doctors – future consultants – said they would not take up the contract and 59 per cent of consultants currently working overseas said they would not return to Ireland to take up the contract.
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An IHCA survey found more than two-thirds of respondents in Ireland and abroad were unlikely to move to the new contract.
Both organisations say the decision whether or not to sign up to the new contract is for individual members. Its appeal is likely to be greatest to post-2012 appointees whose pay would be significantly boosted.
The contract emerged from 18 months of negotiations between the Government and consultant representatives that failed to produce agreement. Prof Matthew Sadlier, chair of the IMO consultant committee, said the Government took the unilateral decision to conclude talks on a new contract and to present a final document on a take-it-or-leave-it basis, without agreement.
The rejection of the contract by the IHCA in particular prompted an angry response within the Department of Health. A spokesman accused the group of negatively impacting sentiment across all consultants by the way it presented the contract to members at a late stage.
One official accused the IHCA of “torpedoing the whole thing. They don’t want to move to a seven-day service, but that is the only direction of travel.”
The IMO cited rostering concerns over evenings and weekends, and concerns about the ability of the Health Service Executive to move consultants’ work location without agreement as key reasons why the contract was rejected.
“This was a missed opportunity by Government to agree a contract that would both encourage existing consultants to transition to and which would be attractive to much-needed new consultants. We are now almost certainly looking at a period of great uncertainty and potentially an ongoing recruitment crisis,” said Prof Sadlier.
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The contract offers doctors salaries of up to €257,000. 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.
The new contract will prohibit consultants from engaging in private work in public hospitals, which is considered a key tool in the separation of public from private care – one of the objectives of the Sláintecare health reform plan. They will be free to work in private hospitals, provided they have met their rostering requirements in the public sector.
Minister for Health Stephen Donnelly said the new contract would increase access to care for patients because staff in public hospitals would be rostered over longer periods of time.
He said the contract had been negotiated with representative bodies “in good faith for a long time” and had been changed when issues were raised during talks.
Separately, the abolition of hospital inpatient charges has been approved by Cabinet at its meeting on Tuesday. The €80-a-day charge (capped at €800 a year) will cease to be levied once legislation to make the change is enacted.
