Brendan Howlin (Wexford, Labour)
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Question 206: To ask the Tánaiste and Minister for Health and Children her proposals which are being put to consultants in negotiations to revise the common contract; the proposals for public-only contracts; and if she will make a statement on the matter. [3030/06]

Dinny McGinley (Donegal South West, Fine Gael)
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Question 217: To ask the Tánaiste and Minister for Health and Children if her proposals for the new consultants' contract will include clinical accountability; and if she will make a statement on the matter. [3052/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 206 and 217 together.

The new contract will set out in detail formal employment arrangements for consultants practicing exclusively in the public sector. Its key features are as follows.

Consultant-provided service is to be delivered by teams of consultants, where the consultants have a substantial and direct involvement in the diagnosis, delivery of care and overall management of patients. As part of a consultant-provided service, consultants will treat all patients and will be remunerated exclusively on a salaried basis. They will not receive additional remuneration for treatment delivered to insured patients. A commitment to public sector service alone will mean that consultants will treat patients only within the public hospital or public community facility.

Each consultant's commitments will be set out in an annual work plan, supported by a series of performance indicators and review mechanisms. Work plans will be in line with clinical need, the nature and volume of clinical workload and the 24-7 nature of health services.

Consultants will work a 39-hour commitment over the 24-7 period agreed and detailed in the work plan, varying by specialty and location. Work plans will follow a framework developed at national level and will be agreed and reviewed annually by consultants, clinical managers and management.

Each work plan will detail specific duties, such as emergency commitments, operating time, ward rounds, outpatient clinics and diagnostic work, regular on-call commitments and involvement in supporting professional activities, audit and competence assurance.

Each consultant will work as an integral part of a multidisciplinary team which is led and managed by a clinical director. As a member of the team, consultants will make decisions regarding the care, treatment and discharge of patients during the absence of a consultant colleague who has lead responsibility for such patients. As a member of a team, each consultant will be incentivised to increase productivity through a performance-related awards scheme.

The primary role of a clinical director will be to manage and plan how services are delivered. Clinical directors will be appointed by the employing authority, will develop and implement protocols for service delivery, will have significant responsibility for how services are delivered and will be accountable for the use of resources. Contracts can be constructed for certain consultants that will allow for a defined and measurable commitment to medical education and training and research.