James Reilly (Dublin North, Fine Gael) | Oireachtas source

I thank the Deputy for raising this important issue. The Government has confirmed on a number of occasions the unprecedented nature and scale of the financial pressures facing the State. Ongoing reform and increased efficiency in service delivery is essential. It is imperative that consultants, given their role within the health system, lead this process.

The recent discussions with the consultants' representative bodies took place in the context of the public service agreement, better known as the Croke Park agreement. The health sectoral agreement constitutes a key element of that agreement. It emphasises that the required reorganisation of health services and the health service workforce will focus on providing, across all settings, planned services over an extended day, from 8 a.m. to 8 p.m., on a Monday to Friday basis and/or a five over seven day basis, while also providing emergency services on a 24-hour, seven day basis. This requires achieving a more productive match between staffing and service activity levels while safeguarding quality and clinical performance.

These requirements provided the background to the recent engagement with the consultant representative bodies. Following direct negotiations on proposals put forward by the management side, management referred the proposals to the Labour Relations Commission, LRC, in accordance with the public service agreement. Intensive discussions between health service employers and the two consultant representative bodies commenced on 13 September 2012 at the LRC and concluded on 17 September 2012. These dealt with a range of matters, including measures to ensure that the relevant parts of the health sectoral agreement within the public service agreement 2010-2014 can be given effect. The management team comprised officials from the HSE, my Department and the Department of Public Expenditure and Reform.

The outcome of this engagement is that detailed proposals have been agreed between the parties. The key provisions include an agreement that consultants will be available for rostering for any five days out of seven as opposed to weekdays, as at present. Consultants can be rostered, where required, on a 16 hour day basis, that is from 8 a.m to midnight, or on a 24 hour day basis, where this is required. Clinical directors will have a much strengthened management role in respect of consultants. Consultants will co-operate with a range of measures to support improved community and mental health services. Consultants committed to measures that ensure that public patients waiting for elective care of any type are seen within clinically appropriate timeframes. It was agreed that consultants will comply with the contractual requirements regarding private practice. Consultants commit to expeditious processing and signing of claims for submission to private health insurers. There will also be more cost-effective arrangements for funding of continuing medical education.

The agreement also puts on a formal basis consultants' co-operation with a range of productivity flexibilities, which will allow for considerable efficiencies in the use of hospital beds, with the potential to deliver a saving of 220,000 bed days annually. Implementation of the agreement will result in more patients being treated more quickly, more efficiently and with greater consultant input.

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