Thursday, 30 November 2017
Department of Health
Hospital Consultant Contracts
174. To ask the Minister for Health further to a recent media programme (details supplied) which reported on a number of consultants that were found not to be in compliance with their contacts, his views on whether this issue does not solely relate to these specific consultants that were highlighted in the programme but rather there are significant numbers of consultants in certain hospitals that fail to meet their contract obligations; and the way in which he plans to address this matter [51390/17]
The HSE collects and reports information monthly, in arrears, in relation to the percentage of public and private work being undertaken at each Hospital on an elective in-patient basis and on a day-case basis. 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 public/private ratio provided for in Consultant Contract 2008 and the public/private bed designation ratio in the 1997 Common Contract held by approximately 10% of consultants. This aggregate data indicates that the majority of consultants are in compliance with their contracts.
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 and 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 to manage private activity 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 am very clear that consultants must deliver their work commitment to the public system. I have asked the HSE to ensure that more robust measures are in place in 2018 to make sure all consultants, those highlighted in the programme and all others, comply with their contractual obligations. 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.