Minister for Health Mary Harney has indicated she may move ahead unilaterally with plans to reform access to hospitals for public patients and appoint hundreds of additional medical consultants on new contracts with the State. Martin Wallreports.
The move follows continuing deadlock between health service management and representative bodies for doctors on a revised contract for hospital consultants. This is one of the key elements of the Government's overall healthcare reforms.
Yesterday, in a confidential report, the independent chairman of the talks on a new contract for consultants said no progress had been achieved in negotiations over the last two months.
Ms Harney said last year that she would move to impose a new contract if no agreement was reached with medical bodies.
Consultants appointed to any new contract would not be able to see fee-paying patients in off-site private hospitals, but would be paid a significantly higher salary to take account of this loss of earnings. It has been suggested that the new salary could be more than €200,000.
The Health Service Executive signalled at the weekend that there could be greater flexibility in relation to private practice in public hospitals.
In a statement last night, Ms Harney said she was very disappointed at the outcome of the talks and said she would be bringing specific proposals to Cabinet shortly.
Sources said last night that the exact nature of the package to be brought to Government had not been decided.
The Department of Health and the HSE are to monitor the outcome of an extraordinary general meeting of the Irish Hospital Consultants Association (IHCA) on Sunday, which is to consider the contract talks.
Among the options considered by health service management in the past has been the imposition of a new public-only contract for all new consultants appointed.
There have also been indications that the Government could insist that existing contractual arrangements in relation to the hours consultants must work in public hospitals be strictly enforced.
Ms Harney said last night that even at this stage she would prefer to see constructive negotiations taking place. However, she was not prepared to let fruitless discussions drag on without results.
"I have a responsibility as Minister for Health and Children to drive forward urgently needed reforms to achieve equitable access to our public hospitals and to expand services in a wide range of medical specialities. Government policy is to recruit over 1,500 new medical consultants and we have an obligation to patients to get on with that.
"I will shortly be bringing specific proposals to Government in relation to the talks impasse, so that Government policy will be implemented, to ensure equitable access to our public hospitals for all patients and to recruit much-needed consultants," she said.
The independent talks chairman, senior counsel Mark Connaughton, said there was a lack of trust between health service management and the consultant representative organisations. Before any talks could resume there would have to be an unequivocal agreement that there would be unconditional negotiations for a defined period, he said. He also maintained that considerable work would be required behind the scenes before any plenary session could be arranged.
In a statement last night, the HSE said it was disappointed that the talks had been unsuccessful in delivering any progress in relation to a new and more workable contract.
It said the HSE concurred with the opinion expressed by the talks chairman that for talks to resume, there would have to be an unequivocal agreement between the parties that there would be unconditional negotiations for a defined period.
The Irish Medical Organisation said it shared the view of the chairman that a framework agreement would be essential before talks could resume. It said a basis could be found for the resumption of talks under Mr Connaughton.
The IHCA declined to comment in advance of its meeting at the weekend.