A new consultant contract should have a more clearly defined public commitment but with shorter hours contracted to the public system, a leading hospital consultant has said.
Prof John Higgins, head of the obstetrics and gynaecology department at University College Cork, called on hospital consultants to play a leading role in bringing about change to hospital services.
Addressing the annual meeting of the Irish Medical Organisation yesterday, he said: "The problems, the issues and the crisis in the hospital service in Ireland have in my view been over-discussed, over-analysed and over-debated . . . We consultants must become and be closely identified by the general public as being problem-solvers and part of the solution."
Prof Higgins, who has extensive experience in the Australian health system where there is a mixture of public and private healthcare, outlined a number of key principals that needed to be included in a new contract.
The obligations to the public hospital system of an individual consultant should be clearly understood, and treatment of a private patient by a consultant should enhance rather than diminish the opportunity of a public patient receiving treatment.
"Different specialities in different-sized hospitals will have different particular requirements. Being an obstetrician in Clonmel is completely different to being a gastroenterologist in Dublin 4.
"If dynamic flexible arrangements are put in place then I think the co-location model recently suggested by the Tánaiste should be an absolute winner."
Prof Higgins called for an expansion of the system of clinical directorates (defined clinical departments with a defined budget). "I suggest each hospital in Ireland should have an overall consultant clinical director who is selected (but not elected) by colleagues. The director should set the strategic direction for the hospital, co-ordinate the service planning for the hospital and, most importantly, control the overall budget."
Dr William Plaisted, president-elect of the American Medical Association, said that, in his experience, politicians and governments were incapable of dealing with the complexities of healthcare. The role of physicians must be to lead and they must adhere to a core ethic of doing what is best for the patient.