Press Release

Minister Harney says IHCA acceptance of new contract paves the way for improved services for patients

The Minister for Health and Children, Mary Harney T.D., today (Friday, 16th May 2008) welcomed the result of the ballot by the Irish Hospital Consultants’ Association (IHCA) on the new contract for medical consultants employed in the public health system.

The Minister said:

“The new contract paves the way for significant changes to be introduced to improve services for patients. It now allows management and clinicians to work together in new ways to serve patients better. In particular it invites clinical leadership for health reform.”

“This is the largest redesign of the consultants’ contract for 30 years.”

“After years of negotiation, it is vital now that this contract is implemented progressively and quickly from September 1st across our health services and that patients see the benefits in tangible ways.”

“The contract is designed to meet the needs of a modernised health service, working seven days a week, with assured quality standards and a much fairer balance for public patients.”

“In hospitals, it means that patients should be seen faster by a senior doctor, admitted faster if necessary, and discharged faster.”

“In community services, it means that patients should receive more care by more senior clinicians, closer to their homes.”

“Given the clinical leadership role of consultants, I expect that this major development will provide the impetus for other healthcare workers to sign up to reformed work practices throughout the sector”.

( A summary of the key features of the new Contract is appended)

Key Features of the New Medical Consultants’ Contract

Team Working

Consultants will work in teams rather than as individuals, thereby facilitating speedier access to hospital services and a more timely discharge of patients.

Clinical Directors

The appointment of Clinical Directors who will lead and manage consultants, as well as managing clinical budgets and services for patients. The Clinical Director will also have a pivotal role in monitoring compliance with the ratio of public to private practice, and taking corrective action where the private practice limit is exceeded.

Three Contract Types

Type A: Will work exclusively for the public hospital and will be remunerated solely by way of salary.

Type B: Will work exclusively for the public hospital but may engage in limited private practice on the public hospital campus (including in a co-located hospital) up to a maximum of 20% of total clinical throughput.

Type C: To be created only in exceptional circumstances where there is a demonstrable benefit to the public health system. Such a consultant will be entitled to treat private patients outside the public hospital campus.

Restrictions on Private Practice

The new private practice provisions, ranging from a total prohibition (Type A Consultant post) to an upper limit of 20% of overall clinical throughput, are designed to improve the position of public patients in terms of their access to the public health system.

Increased Availability of Consultants

•An increase in the length of the working week from 33 to 37 hours.

•An extended working day -8am to 8pm, Monday to Friday.

•Weekend working: Scheduled attendance of up to five hours (where required) on Saturday, Sunday and Public Holidays

These arrangements will result in the increased availability of senior clinical decision makers to treat and discharge patients as part of the transition to a consultant-delivered service, from the present consultant-led service.

Equity of Access to Outpatient Diagnostic Services

A “one for all” access to outpatient diagnostic services for all patients based solely on medical need.