Madam, - The Irish Association for Emergency Medicine (IAEM), which represents consultants in emergency medicine in the Republic of Ireland, wishes to set the record straight in relation to the issue of private fees for our specialty.
Both the HSE and the Minister for Health and Children, Mary Harney, despite being fully briefed by us on several occasions on this in the past, continue deliberately to mislead the public and damage our reputation by saying that the issue of private fees for consultants in emergency medicine is a stumbling block in the current consultant contract negotiations. We are particularly offended by the Minister's assertion that private patients would get preferential treatment in emergency departments if we were to receive fees in relation to their care.
The facts regarding this matter are:
1. The issue of private fees for consultants in emergency medicine is on the agenda for the consultant contract negotiations but it has not been the subject of discussion at any stage, and therefore cannot be seen as a stumbling block in negotiations to date.
2. The contract that consultants in emergency medicine hold is the same as that held by all hospital consultants ie, the Buckley Common Contract, 1997. This states that "each consultant will be entitled to engage in private practice within the hospital or hospitals in which he is employed". There are no exceptions listed.
3. Consultants in emergency medicine working in the old Eastern, Southern, South Eastern, Mid Western and North Eastern Health Board Regions have 10-20 per cent of their basic salary deducted on the basis of being "entitled" to private practice in the public hospital.
Consultants in emergency medicine have, for the past 20 years, attended to private patients in State hospital emergency departments. This practice did not cause any "moral dilemma" for the Department of Health and Children. This question then arises: has this "moral dilemma" anything to do with the fact that for several years consultants in emergency medicine have repeatedly and publicly highlighted the appalling overcrowding in Irish emergency Departments and the adverse effects of this on patient care? The "gagging" clause in the proposed new consultant contract produced by the HSE would certainly suggest that it aims to silence any potential "whistle-blowers" in the future. - Yours, etc,
FERGAL HICKEY, President, Irish Association for Emergency Medicine, Consultant in Emergency Medicine, Sligo General Hospital;
JAMES BINCHY, Honorary Secretary, Irish Association for Emergency Medicine, Consultant in Emergency Medicine, University College Hospital, Galway.