Madam, - Mark Hennessy's report headed "Consultants to lose veto on new appointments" refers to the proposal to subsume the statutory functions of Comhairle na nOspidéal into the National Hospitals Office, (NHO) planned under the Government's recently published Health Service Reform Programme (The Irish Times, June 20th).
Your readers might like to know what Comhairle na nOspidéal does and how it has contributed to the provision of high-quality specialist patient care in our acute public hospitals. The work of Comhairle na nOspidéal is summarised in the eight reports published to coincide with the tenure of appointment of each board; the current (ninth) Comhairle was appointed in February 2001.
Comhairle na nOspidéal is a statutory body established under the Health Act of 1970 to regulate the number and type of consultant posts and to advise the Minister for Health and Children on matters relating to the organisation and operation of hospital services.
The appointment of members to Comhairle na nOspidéal is a statutory function of the Minister for Health whereby "not less than half of the persons appointed shall be registered medical practitioners engaged in a public capacity in the provision of hospital services". The current Comhairle board comprises 18 hospital consultants, three health board CEOs, two Department of Health officials, one nurse, one GP, one trade union official and one senior health manager.
In exercising its function to advise the Minister for Health and Children on the organisation and operation of hospital services, Comhairle na nOspidéal has, frequently on its own initiative, published reports on acute hospital services. It has actively sought to encourage implementation of these reports which have, without exception, recommended significant increases in the numbers of consultants across many specialities and sub-specialities throughout Ireland. Statistics show that the number of consultant posts approved has grown from 987 in 1975 to 1,150 in 1985, to 1,216 in 1995, to the current total of 1,770. In fact, since January 2000 alone, an additional 330 consultant posts have been approved.
The title and content of Mr Hennessy's article - and the Indecon Report on the Professions commissioned by the Competition Authority, upon which the article relies heavily - fail to acknowledge the modus operandi of Comhairle na nOspidéal and the significant body of work carried out by this statutory body throughout its 30 years.
As a member of a previous (fifth) and chairman of the current (ninth) Comhairle na nOspidéal, I can personally testify that not once was there an occasion where the approval of a consultant post was denied (or "vetoed") by the consultants on the board using their inbuilt membership majority.
In my experience, decisions are invariably taken by consensus. The present Comhairle has never had to reach a decision by way of vote.
Comhairle na nOspidéal is curtailed by a government decision, taken at the time of cutbacks in the 1980s, whereby written financial clearance for a new or replacement consultant post must be obtained from the DOHC or the ERHA before being considered by Comhairle na nOspidéal. Without the power to fund posts, the ability of Comhairle na nOspidéal to increase consultant numbers is limited. Consequently, the numbers of consultant posts recommended by Comhairle na nOspidéal in various reports have not yet been fully achieved.
The implication in your article that the consultants who serve the board of Comhairle na nOspidéal operate as a closed group and veto proposed consultant posts, in the interests of maintaining the existing number of consultants, is simply untrue. - Yours, etc.,
Dr CILLIAN TWOMEY, Chairman, Comhairle na nOspidéal, Dublin 2.