Uptake of public-only consultant contract lower in Midwest

Move to phase out private care from public system has had different take-up in different parts of the country

Uptake of the new public-only consultant contract is much lower in the Midwest than the rest of the hospital groups, new figures show.

The contract, which seeks to phase out private care from the public system, was implemented in March of last year, despite proposed terms being rejected by members of the Irish Medical Organisation and Irish Hospital Consultants’ Association.

Its implementation intends to enhance senior decision-maker presence on site, out of hours and at weekends.

Figures obtained by The Irish Times under freedom of information laws provided a breakdown of the first 1,394 consultants who moved to the public-only consultant contract from an existing contract.


Ireland East hospital group had 263 consultants on the new contract, with the RCSI Hospitals Group having 259 and Dublin Midlands having 227.

The Saolta group had 218 consultants on the contract, with the South/South West hospital group having 157. The University Hospitals Limerick (UHL) Group, which is the smallest hospital group, had just 23.

Children’s Health Ireland (CHI) had 87 consultants on the contract, while Breastcheck had 20, corporate had 12 and corporate public health had 19. There were also many consultants on the contract across the various Community Health Organisations (CHOs).

In response to questions, a spokesman for UHLG said the group’s chief clinical director “continues to engage with the consultant workforce to increase take up” of the contract and to “ensure work schedules meet the needs of the service”.

“Local work in this regard has been supported by the national HSE [Health Service Executive], with officials from the Office of the National Director of HR attending UHL in person in May 2023 for an in-person briefing session with consultants,” the spokesman said.

He added that the number signing up to the contract was “steadily increasing”, with the number now standing at a third (84) of the hospital’s total consultants.

“A further 18 consultants are currently transitioning to the contract, and another 10 have filed expressions of interest,” he added.

The figures, released by the HSE, also provided a breakdown by age. Of the first almost 1,400 who signed up to the public-only contract, 300 were over the age of 55. The oldest age of a consultant to take up the new contract was 70, of which there were four, while the youngest age to take up the contract was 31, of which there were two.

The HSE previously wrote to hospitals and community healthcare organisations highlighting concerns about whether they are “deriving the necessary benefits” from the new contract.

Damien McCallion, chief operations officer at the HSE, told the chief executives “weekend and extended day working arrangements” in the pre-agreed areas “needs to be demonstrated”.

As of April, more than half of the country’s consultants had moved to the new contract.

Shauna Bowers

Shauna Bowers

Shauna Bowers is Health Correspondent of The Irish Times