Minister for Health Mary Harney wants the backing of the Government to face down hospital consultants and introduce a new contract against their wishes. Stephen Collinsand Martin Wallreport.
Senior Progressive Democrat sources said Ms Harney was determined to proceed with the new contract just as Minister for Justice Michael McDowell had brought in the Garda Reserve in the face of opposition.
"I want to see undesirable, restrictive practices eliminated. I am therefore determined to introduce radical change to the recruitment of much-needed consultants," Ms Harney said last night.
She is to bring a proposal to Cabinet in 10 days' time seeking approval to advertise for new public hospital consultants.
"At the moment, there are approximately 2,100 consultants in Ireland. I want to see that number increase to 3,600," she said.
Under the proposals, consultants appointed under the new contract would receive salaries of up to €240,000. Informed sources said that there would be premium payments of between €60,000 and €80,000 above the current pay levels for consultants.
The Minister's proposals will also include new measures aimed at ensuring existing private practice rules are strictly observed for consultants retaining the existing contract.
Taoiseach Bertie Ahern yesterday expressed disappointment at the failure of the talks between the consultants and the Health Service Executive, and he said the Government was very anxious to move ahead with the reform of the health service.
"We've been trying hard for a long time to try and get these negotiations to come to fruition. We would still like that to happen. The Minister has said that she will be bringing proposals to the Cabinet shortly and they will have to be discussed and addressed at the Cabinet," he said during a visit to Cork.
Fine Gael health spokesman Dr Liam Twomey last night strongly supported Ms Harney's planned reforms but said she should personally intervene to make one last attempt to get agreement.
"She should go in herself and take control and, if there is no agreement after one or two meetings, she should exercise the nuclear option and I will back her," he said.
The Irish Patients' Association also backed her. "We support the Minister's decision to go ahead with the immediate recruitment of new public-only consultants with new public-only contracts. The serious issue is that there are some 250,000 outpatients awaiting a consultant's appointment, some for years. In monetary terms, this is €31 million in initial private consultations fees," said Stephen McMahon, chairman of the association.
"Patients are living in a hell waiting for consultants' appointments. This impasse is unacceptable to patients."
The Minister's plan would involve an international advertising campaign initially to secure more than 200 consultants in a number of speciality areas. One type of contract would involve doctors being employed exclusively in the public services and paid a salary of up to €240,000. It is unclear whether this figure incorporates a potential bonus payment of up to 20 per cent also to be in the new contract.
A second type of contract would allow doctors to see fee-paying patients in the public hospital or in any co-located private hospitals established on the campus.
The consultant with private practice rights would have a lower salary. They would not be eligible for the bonus scheme.
The new contract would be offered to all 2,100 existing public hospital consultants in addition to the new employees.
Ms Harney said last night it was in the interests of consultants themselves a new system was introduced that would remove career bottlenecks. To achieve this, it was necessary to improve attraction and retention policies for qualified Irish medical doctors. "I want to create more employment opportunities for our talented young doctors and I want to help them to become consultants at an earlier age," she said.
The Irish Medical Organisation warned her against imposing a new contract and said this would exacerbate the gulf between the parties.