In letters and articles, some consultants dispute statements in "An Unhealthy State" about their working practices. The following gives details of sources of information relating to some of the more contentious issues:
Consultants insist their public sector working hours are monitored. The 1989 Report of the Commission on Health Funding and the Department of Health, their ultimate employer, disagree.
Consultants insist they are committed to public patients. The Commission on Health Funding concluded after discussions with consultants, among others, that, while very many of them might well fulfil their responsibilities to public patients, "it is generally accepted that, as a result of the incentive structure, some consultants do not".
Consultants receive salaries for their public commitments and individual fees for seeing private patients.
The Government White Paper on private health insurance, published last year, states: "Rational economic behaviour would suggest that a stronger incentive exists for those consultants who are significantly involved in private practice to concentrate a disproportionate amount of personal time on these private patients."
On the issue of the role of private practice in perpetuating the two-tier system, the Government White Paper on private health insurance describes the growth of private medicine as a potential threat to public patients' access to the services of the public hospital system.
The 1998 Report of the Review Group on the Waiting List Initiative, which numbered five consultants and eight doctors among its 12 members states that among the reasons why many countries have found it hard to eliminate waiting lists is that "some hospitals or consultants may find it attractive to maintain a public waiting list because a proportion of those waiting may opt to be treated privately."
The Economic and Social Research Institute (ESRI) report on private practice in public hospitals, published last week, discloses a high level of use, in some hospitals, of public beds by private patients.
The Government has attempted to ensure equal access for public patients to public hospitals by limiting the number of private beds.
The ESRI report suggests that, while there is no evidence of consultants using public beds for elective admissions for private patients, present monitoring systems are inadequate.
An alternative way to promote equity of access, it says, would be to pay consultants private fees only when their patients are in private beds.
On the issue of consultants' delegation to junior doctors, one correspondent challenges the statement by Prof Muiris FitzGerald that 80 per cent of patients seen at outpatient clinics are seen by non-consultant hospital doctors rather than consultants.
Prof FitzGerald is supported by the third Kennedy report on the Dublin hospitals, which in 1991 observed that almost 80 per cent of all patients attending out-patient clinics were return patients, the majority of whom were seen by "quite junior doctors".
On the issue of consultants' public pay, I will cede one point to Mr McNeice of the Irish Medical Organisation .
The series stated that some consultants, particularly in rural areas, had very little private practice and worked long hours for public patients.
It should have continued that these consultants could receive maximum public earnings of £103,000, including £17,000 in allowances.
Since, due to editing error, the word "could" was omitted, it might have appeared to the reader that such consultants invariably received maximum on-call and emergency allowances, which is not the case.
On the issue of consultants' private pay, Mr McNeice is wrong when he describes figures quoted for private income from the VHI as "entirely without foundation".
The global figure of £110 million for VHI payments to consultants last year was supplied to the Irish Hospital Consultants' Association by the VHI and has been independently verified.
While he may dispute how the global figure was divided between individual consultants, it is correct.
