Tom Hayes (Tipperary South, Fine Gael)
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Question 81: To ask the Tánaiste and Minister for Health and Children if she will publish her proposals for the new consultants' contract; and if she will make a statement on the matter. [15513/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The new contract will set out in detail formal employment arrangements for consultants practising exclusively in the public sector. Its key features can be summarised as follows. It provides for a consultant-provided service — a service 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, that is, 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-seven nature of health services. Consultants will work a 39-hour commitment over the 24-seven 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- reviewed annually by consultants, clinical managers and management. Each work plan will detail specific duties, for example, 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; they will develop and implement protocols for service delivery; they will have significant responsibility for how services are delivered; and they will be accountable for the use of resources. In regard to medical education and training, contracts can be constructed for certain consultants that will allow for a defined and measurable commitment to medical education and training and research.

A position paper outlining these 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. However, at a further meeting on 9 February, the medical organisations refused to engage in substantive discussions on these proposals and talks were adjourned. While the next 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 the resumption of substantive and intensive negotiations at an early date.