Clare Daly (Dublin Fingal, Independent)
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300. To ask the Minister for Health his plans to implement a system of clocking in for consultants in hospitals to prevent the abuses revealed by a programme (details supplied) which have led to some consultants being paid tens of thousands of euro for work they did not do and to increased wait times for persons in public hospitals. [50853/17]

Simon 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. The framework for the regulation of a consultant's private practice is contained in Section 20 of Consultant Contract 2008. It provides that the public to private practice ratio is to be implemented through the Clinical Directorate structure. It also gives the employer of the consultant concerned full authority to take all necessary steps to ensure a Consultant's practice shall not exceed the agreed ratio of public to private practice.

However it is 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 the responsibility of management to make sure these contracts are being enforced and to put in place structures that support compliance. 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. It is a matter for the HSE and hospital management to determine whether a system of clocking in for consultants should be part of these structures.

In the longer term I have established an independent group, chaired by Dr Donal de Buitléir, to examine the impact of separating private practice from the public hospital system. This was one of the key recommendations of the Sláintecare Report.