Seán Crowe (Dublin South West, Sinn Fein)
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Question 63: To ask the Tánaiste and Minister for Health and Children if she will report on progress to date in the delivery of Action 89 of Quality and Fairness — A Health Strategy for You, which promised agreement on a revised consultants' contract to provide greater equity for public patients in acute hospital services; and if she will make a statement on the matter. [21305/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The aim of the negotiations on the new consultants' contract is to resolve a number of key elements of the current system in order to promote equity of access, organisational improvements, flexible work practices and more clinical involvement in, and responsibility for, management programmes.

Talks on a new contract commenced on 24th 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. This paper includes such items as: 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. i.e 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 / 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 multi-disciplinary 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 appointedby the employing authority; 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. 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/research.

The medical organisations have thus far not engaged in substantive discussions on these proposals.

At a further meeting on 9 February the talks were adjourned without any further date being set for their resumption. The independent chairman has, however, maintained contact with both sides.

I met a delegation from the IHCA on 12th May 2006. At that meeting, I indicated to the delegation that any outstanding issues would be most appropriately addressed in the context of direct discussions with management. To this end, I emphasised the need for talks to resume as soon as possible. I understand that in response to this, the IHCA has now made contact with the independent chairman with a view to arranging a further meeting with health service management.