Taoiseach Michéal Martin has warned the board of the Rotunda hospital to reflect on its decision not to fully implement the Public Only Consultant Contract (POCC).
Speaking on Saturday in Cork, Martin said: “It’s very clear – it will proceed as agreed – the board of the Rotunda will have to reflect ... there can’t be any deviation from that, because this was a new departure that Government negotiated with the representatives of doctors. Doctors voluntarily signed up to it.
“The hospital itself signed up to a service level agreement with the Health Service Executive which also has to be honoured.”
Martin said it was clear the private model of health in maternity services and obstetrics was not sustainable in the modern era.
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Meanwhile, Minister for Health Jennifer Carroll MacNeill will not meet the board of the Rotunda until it confirms it will align with Government policy and stop public-only consultants from providing private care.
On Friday, the board of the biggest and oldest maternity hospital in the country sought a meeting with Carroll MacNeill to “explain the rationale” of its decision to permit private practice on-site by doctors who had signed contracts committing to only carrying out public work.
Derek Tierney, the secretary general of the Department of Health, has now responded to the Rotunda.
The HSE had previously sought extensive details from the Rotunda of the number of public-only consultants who have been providing private care at the hospital, including how much the Rotunda has billed for such treatment.
In a statement on Saturday, the Department of Health said Tierney had noted the Rotunda’s intention to reply to the HSE’s question by Monday’s deadline.
The statement said the department believed it “essential that this response directly addresses the matters raised and clearly demonstrates alignment with Government policy – which provides for the removal of private practice from public settings.
“In this context, any further explanation of the Board’s position must be directed towards confirming how the Hospital will bring its arrangements into conformity with Government policy, its contractual obligations under the signed service level agreement of 2026 and compliance with the terms of the POCC generally,” the statement said.
“Once the HSE has received and considered the Hospital’s response, and there is clear assurance that the position is aligned with Government policy, the Minister would of course be happy to continue to engage further on all aspects of the future development of the Rotunda and its services.”
Tensions over the matter have been building between hospital management and Government in recent days.
Following an extraordinary general meeting on Friday, the hospital’s governing power declined to back down from its decision to allow public-only consultants to continue offering private care on-site.
The number of consultant obstetricians on public-only contracts at the Rotunda is small – just one doctor delivered two private patient babies under this model in the first quarter of the year. However, it is understood the hospital is defying the Government in a bid to retain private maternity care in publicly funded hospitals.
Speaking on RTÉ Radio’s Saturday with Cormac Ó hEadhra, Fianna Fáil Minister of State Robert Troy said there have to be “consequences” should the board not ensure the public contracts are “implemented to the letter of the law”.
Outlining potential consequences, Troy said withholding cash would be the “nuclear option”, but fines or withholding cash for further capital investment were also possible.
“Nobody forced any consultant to sign up to this contract,” Troy said, adding that consultants who signed up knew “full well” they were prohibited from operating private practice in public facilities.
He said the Minister for Health would “forcefully implement the intention behind these public contracts”.
