Fears hospital consultants will quit Ireland for jobs abroad over 'restrictive' contract

One of the concerns with the Sláintecare contract is its power to move staff to any location in Ireland, as employers see fit.

Fears have been raised that Irish consultants will leave the country for work elsewhere, and those already abroad will not return, as a result of the proposed Sláintecare contract.

Consultants across Ireland, and further afield, have voiced their concerns about the proposed contract, the details of which were revealed in recent weeks.

The main concerns relate to the contract's power to move staff to any location in Ireland, as employers see fit, its control over the intellectual property of staff, and its ability to prevent doctors from advocating publicly for their patients or services.

Prior to 2020, public-health specialist and Dublin native, Dr Niall Conroy, had been living in Trim, Co Meath, with his wife, who taught at a local primary school.

However, the lack of a consultant contract for public-health specialists in Ireland convinced Dr Conroy to move to Australia, where he leads a Covid-19 response team in Queensland. He said the Sláintecare contract would not entice him home.

"I have a very fair consultant contract here in Australia and wouldn't be interested in signing up for something that tries to exert so much control over doctors," Dr Conroy said.

He highlighted a number of concerns with the Sláintecare contract, including its prohibition of doctors advocating for patients or services, its ownership of any publications by doctors, and its ability to move doctors to different locations.

Dr Conroy said that doctors working abroad will be put off returning to Ireland because of the contract and that it will drive newly qualified consultants away.

"There's a real opportunity here for the HSE and doctors to sit down and design a contract that is good for patients and for healthcare delivery," Dr Conroy said.

"But, as things stand, this isn’t it." 

Dr Sarah Casey has completed her basic training in psychiatry and is undergoing higher specialist training, with a view to being eligible for a consultant position in July 2024.

While she had plans to stay in Ireland, Dr Casey said the Sláintecare contract has changed that.

"I am now looking for fellowship opportunities and future consultant posts outside Ireland, likely the UK, Canada, Australia, or New Zealand," said Dr Casey,  a Down native, who said her colleagues are doing the same.

Dr Casey also took issue with the idea that doctors could be relocated on a whim, cannot advocate for patient care or services, and would not own their own intellectual property.

She agreed with Dr Conroy about the impact this contract will have on Irish consultants, both at home and abroad.

"Those abroad are unlikely to come home, based on these contract terms, and we will continue to lose clinicians to more attractive opportunities across the globe," Dr Casey said.

"I believe this contract will lead to further vacant consultant posts, more trainees emigrating on completion of training, longer waiting lists, and a detrimental effect on patient care." 

A spokesperson for the Department of Health said the new contract contains "significant elements" from a previously agreed-upon contract.

The spokesperson said that the department and the HSE have written to representative unions to express "openness to engage on the draft contract".

"The responses from the representative bodies to an invitation to engage on the contract are under consideration by the department."