Mary Harney (Dublin Mid West, Progressive Democrats)

Under the terms of the 1997 consultant contract, each consultant is contracted to work within the normal working week from Monday to Friday. Most consultants are also available on an on-call basis outside these hours. In 2003, the national task force on medical staffing recommended that health professionals should work as part of a multidisciplinary team centred on delivering quality patient care over the full 24-hour period. Since 2003, management has sought to begin substantive negotiations on a new contract with the medical organisations. For a number of reasons, including the organisations' opposition to the extension of the clinical indemnity scheme to consultants, both the IMO and the IHCA did not begin talks until November 2005.

Talks on a new contract began on 24 November 2005 under the independent chairmanship of Mr. Mark Connaughton SC. At that meeting and at a further plenary meeting in December, both the IHCA and the IMO indicated that they required a number of issues to be addressed before they could engage in substantive negotiations on a new contract. A position paper outlining proposals on a new employment contract for consultants working in the public health system was tabled by management at a plenary meeting on 26 January 2006. The medical organisations have refused to engage in substantive discussions on these proposals. The talks were adjourned at a further meeting on 9 February. While a further meeting between management and the consultant representative bodies has not yet been arranged, the independent chairman is maintaining contact with both sides with a view to arranging a formula to effect the resumption of substantive and intensive negotiations at an early date.

In its proposals to the medical organisations, the management team has outlined the need for consultants to work a 39-hour commitment over the 24-hour, seven-day period agreed and detailed in an annual work plan for each consultant. Work plans will follow a framework developed at national level and will be reviewed and agreed annually by consultants, clinical managers and management.

Additional information not given on the floor of the House.

The key objective of the new contract is to address the needs of all patients by achieving greater equity and increasing productivity in a consultant-provided 24-hour, seven-day hospital service. This will ensure that patients have access to senior clinical decision makers, that is, the consultants, when they need them. Rapid access to consultants will speed up diagnosis and treatment and reduce the need for repeated reviews by junior medical or other staff. It will also mean that patient or clinical need determines the nature of rostering arrangements for consultants and that patient access to care and the speed with which care is delivered is determined only by clinical need.

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