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HSE concerned over whether hospitals are benefiting from new public-only consultant contract

HSE’s chief operations officer has written to heads of hospitals and community healthcare organisations about implementation of contract

Damien McCallion, chief operations officer at the HSE. Photograph: Alan Betson
Damien McCallion, chief operations officer at the HSE. Photograph: Alan Betson

There is “considerable concern” as to whether hospitals and community healthcare organisations (CHOs) are “deriving the necessary benefits” from the new public-only consultant contract, a senior official in the HSE has said.

The contract, which seeks to phase out private care from the public system, was implemented in March of last year, despite proposed terms being rejected by members of the Irish Medical Organisation and Irish Hospital Consultants’ Association.

Almost half of the consultant workforce is now on the new public-only consultant contract, according to the most recent figures.

In a letter dated April 11th, seen by The Irish Times, Damien McCallion, chief operations officer at the HSE, wrote to the chief executives of hospitals and CHOs about the implementation of the contract.

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“There is considerable concern emerging as to whether our hospitals and CHOs are deriving the necessary benefit from the contract. This is one of the key priorities under Sláintecare and a considerable level of investment has been made with each new contract providing an additional investment of €50,000 per contract holder,” the letter said.

Under the public-only contract, consultants can be asked to work 8am to 10pm Monday to Friday and 8am to 6pm Saturday as part of their core 37-hour week

“This concern has now escalated to Ministerial, Secretary General and CEO level.”

Under the public-only contract, consultants can be asked to work 8am to 10pm Monday to Friday and 8am to 6pm Saturday as part of their core 37-hour week. Any private work they do has to take place outside their rostered hours, away from the public facility.

Basic pay under the contract ranges from €217,325 to €261,051 on a six-point scale, with additional pay for on-call duties and overtime, and supports for medical education training and research.

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According to Mr McCallion’s letter, it was agreed with chief executives initially to focus the use of the contracts on unscheduled and emergency care, waiting lists and community mental health.

“In particular, weekend and extended day working arrangements in the above settings needs to be demonstrated,” he said.

Mr McCallion said a national oversight group was established to oversee implementation of the new system to ensure delivery of benefits.

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“There were a significant number of sites where no obvious benefits are being derived despite large numbers transitioning to the contract. In the event that this is the case, it is really important that you immediately review all services and contracts to ensure that maximum benefit is derived from the contract,” the letter said.

Mr McCallion sent the recipients a survey to detail their 2024 plans, which they were required to have completed by last Friday.

“We need to understand where each site is at now and what the plan is to ensure increased benefit from the contracts if not yet delivered.”

Shauna Bowers

Shauna Bowers

Shauna Bowers is Health Correspondent of The Irish Times