Written answers

Tuesday, 28 November 2017

Department of Health

Hospital Consultant Contracts

Photo of John CurranJohn Curran (Dublin Mid West, Fianna Fail)
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467. To ask the Minister for Health his plans to carry out a full review of the operation of consultants' contracts by hospital and ensure that all consultants work their full allocation of hours in view of recent media revelations (details supplied) regarding the contracts and hours worked by consultants in public hospitals. [50669/17]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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A key objective of Consultant Contract 2008 is to improve access for public patients to public hospital care. Latest data from September 2017 shows that the public-private mix at a system level stands at 82% public for elective in-patient work and at almost 86% for day-case work. This is consistent with the typical 80/20 split provided for in the consultant contract.

Arrangements concerning implementation and monitoring of Consultant Contract 2008 including the provisions in relation to private practice are matters for the HSE in the first instance. Section 20 of the Contract provides a framework for the regulation of private practice, monitoring of the applicable ratio and steps to be taken where it is exceeded. The responsibility for reporting individual consultant compliance with their contract was formally delegated to the Hospital Groups in 2014. The main reason for this was to ensure local accountability. Hospitals know their consultants and the work they deliver.

However it seems clear that the arrangements in place are not robust enough to deliver compliance in all circumstances and, as a result, some consultants are able to engage in private practice activity at levels that significantly exceed the permitted levels, or else they may engage in significant levels of off-site private practice, although their contract does not provide for this. It is incumbent on publicly-funded hospitals to ensure compliance with the terms of the contract, including the provisions in relation to private practice. For some time my Department has been working closely with the HSE on this. It wrote to the HSE in July requesting that the HSE satisfy itself that no consultant is engaged, or will be permitted to engage, in private practice beyond the level, if any, provided for in their contract.

I am very clear that consultants must deliver their work commitment to the public system. It is the responsibility of management to make sure these contracts are being enforced and I have asked the HSE to ensure that more robust measures are in place in 2018 to make sure consultants comply with their contractual obligations. I will require absolute assurances on this point.

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