Dr. Peadar Gilligan:

The IMO, on behalf of doctors in Ireland, thanks the committee for the invitation to this meeting following on from the "RTÉ Investigates" programme which aired on 21 November 2017 on RTÉ. We are happy to engage with the committee on the content of that particular programme. However, at the outset, it is important that we advise the committee that litigation is currently before the courts in relation to the failure by the Government and the HSE to implement contractual pay increases to consultants. Having taken legal advice on the matter we will be unable to comment on the issues or matters before the courts.

In relation to the issues which the committee wishes to discuss we highlight the following points. The committee will be very much aware that there is no single uniform consultant contract. Currently, there are seven clinical consultant contracts held by active working consultants. The earlier arrangements dating from 1991 and 1997, respectively, are still held by several hundred consultants and allow those consultants to engage in off-site private practice with limits determined by the type of contract held.

Over 80% of consultants now hold a 2008 contract. The 2008 contract was several years in the negotiating but also was predicated on co-located hospitals allowing consultants to provide care to patients in a co-located private hospital on public hospital campuses. With a small number of exceptions, these facilities have not materialised. That has presented a significant challenge for capacity in the public hospital system. The contract types offered in 2008, A, B, B* and C, allowed for up to 30% of a consultant's time to be set aside for private practice depending on the contract that the consultant signed. This in turn may have depended on the type of contract held by a consultant prior to signing the 2008 contract.