Fresh crisis in talks on doctors' contract

Ironically, on the day that health service management and medical representative bodies finally got around to talking about salary…

Ironically, on the day that health service management and medical representative bodies finally got around to talking about salary levels for a new consultant contract, the entire process has, quite suddenly, been thrown once more into potential crisis.

In a letter to Minister for Health Mary Harney yesterday afternoon, the independent chairman of the talks, senior counsel Mark Connaughton, signalled that the Government's deadline for conclusion of a deal is unlikely to be met.

"My current view, as expressed to the parties this morning, is that there is still a considerable divergence on many issues and there has been a reluctance to demonstrate agreement on matters that should not be controversial. I would not, therefore, be optimistic that a concluded agreement can be reached by April 17th next," he said.

While the Department of Health last night said it believed there was still time to reach an agreement, it maintained that the Government's deadline of April 17th would stand.

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From that date the Health Service Executive (HSE) will be instructed to begin advertising the first of around 350 new consultants - initially about 100 posts - to be appointed this year under revised terms and conditions.

The medical organisations have warned that any move by the Minister to impose a new contract without agreement would be resisted, raising the prospect of further conflict in a health service already disrupted by the ongoing industrial action by 40,000 nurses.

The Irish Medical Organisation (IMO) is expected to discuss the developments at its annual general meeting in Killarney next week. The Irish Hospital Consultants Association (IHCA) will consider its response to any Government move at a special meeting to be held on April 22nd.

This could involve organising a boycott of the new posts and refusing to serve on interview panels to assess candidates. General administrative committees in hospitals could also be hit although full-scale industrial action does not appear to be on the cards at present.

Yesterday, health service management proposed that consultants operating a revised contract should be paid salaries of up to €205,000 per year.

However, the immediate reaction from the IHCA and the IMO was quite negative.

Both organisations signalled that because of the longer working week envisaged under the new contract, some existing consultants would end up receiving less per hour than they were currently earning.

They said that under the proposed new contract doctors would work a 39-hour week compared with a 33-hour commitment at present. These claims are disputed by management.

Health service management has proposed two types of contract. Doctors appointed under the first, known as Type A, would have no private practice rights and would be full-time employees. The Type A contract would attract a salary of €180,000-€205,000. There would be a six-point scale with €5,000 increments for each of the first five years.

There would also be a performance-related bonus of up to 20 per cent.

The second type of contract would allow for limited private practice in public and co-located private hospitals.

The salary scale proposed for the Type B contract runs from €160,000-€185,000.

These scales would apply nationwide.

At present salaries for hospital consultants range from €143,738 to €186,922 depending on type of contract, geographic location or speciality involved.

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.