Simon Harris announces public-only consultant contract to come into effect next summer

From next summer no more consultant contracts will be issued in the public health service that allow private practice in public hospitals, Health Minister, Simon Harris, has announced.

“If you want to do your private practice — no problem at all. But if you are a new consultant you may only do it in a private health facility,” said the minister.

Mr Harris said that in public hospitals people should be treated on the basis of need, not the size of their bank balance. The State is not paying for public hospital beds for the benefit of private health insurance companies while patients wait in overcrowded emergency departments, he said.

Mr Harris has a announced a new public-only consultant contract, with no provision for private practice either on or off-site.

Under the new proposals, hospital consultants are to be offered a salary of up to €252,150, which represents a significant increase on the rates currently applying to post-2012 consultants.

The minister said he welcomes the “constructive comments” from the doctor representative bodies on the Governments plan to move toward single-tier public hospital care.

From next summer all medical specialists will be appointed under a new Sláintecare consultant contract that will not allow private practice in public hospitals.

Mr Harris said his job is to end a practice that is “bizarre” and is not in line with best international practice.

He has to make tough decisions and this is one of them:

You have to actually say to vested interests — things are going to change around here.

The minister said there will be “real and meaningful” talks with the Irish Medical Organisation and the Irish Hospital Consultants Association in January about pay and other matters, including access to theatres and rosters:“The salary has been decided by the Government.

It is Government policy but there are other issues that I do want to talk to them about."

Mr Harris said doctors decide to work in the public or private health service at home or abroad not just because of the salary, but that is a big part.

The minister said the new salary being offered under the new public-only contract will make Ireland very competitive.

Mr Harris said it is one of the highest rates of consultant pay for the public health service among the 36 member countries of the Organisation for Economic Cooperation and Development (OECD).

Also making the new contract very attractive is having access to research, training opportunities and links to academic institutions.

Mr Harris said he wants to have consultants rostered so there is 24/7 health service that will see theatres opened at weekends.

The new contractual arrangements will apply to new entrants only. Existing consultants will be able to switch to the new proposed contract but will retain the option to remain on their existing contract.

The Government has agreed to increase the overall number of consultants working in public hospitals by 1,000 by 2030, bringing the overall number to more than 4,200.

Q&A: What does the change mean?

What has been announced?

The Government has decided to move towards single-tier public hospital care that will result in a more efficient hospital service and shorter waiting times for public patients.

How will this be achieved?

A new public-only contract will be introduced next year that will have no provision for private practice either on or off-site.

Will more consultants be appointed?

An additional 1,000 consultants will be recruited to public hospitals increasing the overall number to more than 4,200 by 2030.

What does this mean for patients?

Patients will be seen and treated based on clinical need rather than on the ability to pay.

How will the change affect private patients?

The change will happen progressively over a number of years so anyone with health insurance can continue to receive private care in public hospitals for the foreseeable future.

What about services for private patients?

People will still be able to go to a private hospital but nobody will need to have private health insurance to access services provided in public hospitals.

What salary is being offered to consultants?

The current €222,460 pay rate will increase to €252,150 no later than July 2022.

How much is this going to cost?

It is estimated as €28m during the first year, rising to €183m in year-10.

What about the loss of private income by public hospitals.

Income from private insurance is currently about €533m and the introduction of the new contract will see it fall by €7m during the first year; €16m in year-two; around €25m in year-three and by €148m in year-10.