The introduction of new arrangements that would see hospital consultants treat only public patients in public hospitals is one of the key pillars of the Sláintecare health reforms. It is now over 18 months since the then government announced that all future consultant appointments would be on the basis of the doctors concerned treating only public patients. However a new contract will need to be agreed to facilitate the proposed Sláintecare arrangements.
In late April the Department of Health proposed salaries ranging from from €188,902 to €226,909 on a six -point scale for the new contract. This would rise to €209,915 – €252,150 when the full rewinding of financial emergency cuts for the highest earners in the public service is completed next year. At the time the Department of Health said Minister Stephen Donnelly wanted to introduce by the Sláintecare contract by the end of June.
Initial talks in May did not go well. Medical organisations were unhappy at what they maintained was the stance of the department that the contract proposals were "not for negotiation but for implementation with a provision for 'feedback'". New efforts to negotiate a revised contract will now begin in September in a process to be chaired by barrister Marguerite Bolger.
The Minister has told officials to drop earlier controversial proposals which would have imposed restrictions on the right of consultants to advocate on behalf of their patients – which begs the question as to why such measures were put forward in the first place. There are big issues that will need to be resolved when the talking starts.
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A key element for the medical bodies will be ending the two-tier pay system that sees consultants appointed after 2012 receive up to €50,000 per year less than longer-established colleagues. The medical organisations argue this has contributed to the inability of hospitals to fill about 700 specialist posts on a permanent basis.
The new talks are likely to be challenging. But it is imperative that the process is concluded as soon as possible.