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FOUR WEEKS ago, Minister for Health Mary Harney declared that agreement had been reached with hospital consultants on a contract that would provide significant improvements in public patient care. Last weekend, the Irish Hospital Consultants' Association (IHCA) said it would not recommend the terms of a new contract to its members until the end of next month.

What is going on? And why have the needs of those at the heart of this exercise - sick patients - been put on hold once again? It has taken nearly five years of intermittent negotiations to bring us to this point. In that time, the dysfunctional nature of many of our hospitals has become obvious. With no agreement on a new contract, natural wastage reduced an already inadequate number of consultants. Last year, in a show of political determination, 68 new consultant posts were advertised - and then frozen - pending negotiations with the IHCA and the Irish Medical Organisation (IMO). Those jobs remain unfilled and unfortunate patients are suffering and dying.