The Minister for Health, Mr Martin, is to seek immediate renegotiation of the common contract of hospital consultants after the publication today of the Hanly report on medical staffing in the health service.
Mr Martin said implementation of the report's recommendations, which will initially be applied to two pilot areas, will depend on immediate discussions with doctors' representative organisations, including the Irish Medical Organisation and the Irish Hospital Consultants Association. The pilot areas will be the mid-west and east coast area health board regions.
Both the IMO and IHCA say they have been seeking negotiations with the Department of Health for some time on a new contract for hospital consultants. However, the talks could take some considerable time, which could put off implementation of the Hanly taskforce report for an indefinite period. The Hanly taskforce set out to devise ways to ensure hospitals have an adequate medical staff after the hours of non-consultant hospital doctors (NCHDs) are cut under a new EU working time directive and to examine ways in which a consultant-provided, rather than consultant-led service, could be established.
Under the directive, the hours of NCHDs have to be cut to 58 hours a week by next August, to 56 hours a week by August 2007 and 48 hours a week by August 2009. At present some are working up to 129 hours a week.
Suggestions yesterday that the Government would appeal to the EU to give it extra time to prepare to implement the directive were denied by Mr Martin. "We are seeking no derogation from the EU on this at all," he said.
Mr Martin said the directive was passed and so the State had to take measures to ensure compliance with it. If the State fails to comply with the directive it could be liable to large fines. The Hanly report, full details of which were published in The Irish Times in June, says the hours of NCHDs can't be reduced by employing more NCHDs. The solution, it says, lies in employing 1,300 more hospital consultants by 2009 and 1,870 more by 2013, at a cost of some €111 million. They will be rostered to work around the clock, which will require the renegotiation of the consultants' contracts.
If what is recommended for the mid- west and east coast area health boards by Hanly is used as a blueprint for other areas, the role of many small acute hospitals will be radically changed.
Hanly says there should be a single major hospital with a full range of services in the mid-west (Limerick Regional Hospital) and in east coast health board areas (St Vincent's, in Dublin). All other hospitals in those regions would concentrate on treating minor injuries and doing elective day care procedures.