The revised contract impasse looms over the appointment of all consultants, writes Martin Wall, Industry Correspondent
The 60 consultant posts announced yesterday will not be advertised for at least several weeks to allow time for the latest attempt to negotiate a new contract for senior doctors.
The HSE has agreed to a request from the independent chairman of the contract talks not to make any definitive moves on the appointment of new consultants on revised conditions until the middle of September to facilitate a new round of negotiations between health service management and the Irish Hospital Consultants Association and the Irish Medical Organisation.
The medical organisations yesterday said they welcomed in principle the appointment of additional consultants by the HSE. However, they warned management against taking any steps that could undermine efforts under way to revive full talks on a new contract.
A revised contract for hospital consultants is a key element of the Government's healthcare reforms. However, the process has been beset for years by rows, walk-outs and missed deadlines.
The Government wants to appoint more than 1,500 additional hospital consultants in a move towards a consultant-provided service rather than the present system whereby consultants lead teams of non-consultant doctors who are training in their specialties.
The Government has insisted that it can only appoint the additional consultants on conditions very different to those in place already. In essence the Government wants to introduce a new contract which would give consultants either no rights or very restrictive rights to private practice.
Consultants would also have to agree to work an extended day, to be rostered at weekends and to operate in teams under the direction of a clinical director. The proposed salary for the new contract is up to €205,000 plus potential bonuses of up to 20 per cent.
The medical organisations are concerned about private practice rights and a "gagging clause" which they believe would prevent senior doctors from advocating publicly on behalf of patients and from publicising potentially embarrassing issues such as cuts in services.
The talks on a new contract collapsed last April after the Government decided to advertise for an initial 68 additional consultants on revised terms not agreed with the medical organisations.
In the wake of the general election, new life was breathed into the process and discreet contacts have been under way for some weeks now with a view to holding full-scale negotiations in early September.
If all goes well at these talks a new contract could finally be agreed between the parties within weeks. However, serious issues remain outstanding and if these negotiations fail, like all the others before them, the Government seems likely to press ahead with its plans to recruit doctors not only for the 68 consultant posts it advertised in April but also for the 60 new positions announced yesterday.
Such a move would be likely to trigger the showdown between the Government and the consultants - traditionally one of the most powerful groups in the country - which many believe has been in the offing for some time now.