The body representing the largest group of hospital consultants in the State, the Irish Hospital Consultants' Association (IHCA), agreed at the weekend to re-enter negotiations with health service management on a new contract of employment for its members.
The negotiations have been stalled since February but they now look as if they will restart later this month or early next month if the other body representing consultants, the Irish Medical Organisation, also agrees to return to negotiations.
The IHCA represents around 1,800 consultants and the Irish Medical Organisation (IMO), which represents the other 800, will meet on October 26th to decide whether it should also accept proposals put forward by the independent chairman of the talks, Mark Connaughton SC, aimed at getting all sides back to the table. The Health Service Executive (HSE) board accepted the proposals last Thursday and it is expected the IMO will also accept them.
The main reason for the breakdown in talks was the decision by the HSE board in January to no longer issue category II consultant contracts, which allow consultants working in public hospitals to also undertake lucrative off-site private practice. It wanted to issue public hospital-only contracts.
However the HSE has now agreed to lift its ban on the issuing of category II contracts for the duration of the talks, which it hopes can be concluded after two months' intensive negotiations.
The other contentious issues, such as the pricing of any new contract and what should become of category II consultant contracts, sanctioned but not filled at the time of the HSE board decision in January, will now be discussed at the talks table.
A new contract for consultants is seen as an essential building block of the health service reform programme and the Government hopes a deal can be reached at the negotiations which will see consultants working in teams to treat patients around the clock in all hospitals, thus reducing dependence on junior doctors. Minister for Health Mary Harney and HSE chief executive Prof Brendan Drumm have welcomed the IHCA decision to return to talks. Ms Harney said she hoped all the issues could be agreed within a two-month timeframe. Prof Drumm said: "I think we've all got to be flexible on this. I mean from the HSE's perspective we are going to have to give a little, the consultants are going to have to give a little".
The IHCA decision was taken at its annual conference in Mullingar on Saturday where its president, Dr Mary McCaffrey, said if consultants were to work around the clock then other staff would have to change their work patterns. "If the public contract for hospital consultants is to be structured over a different working week then clearly there are many other personnel - paramedical, nursing and administrative staff - who must also be prepared to change their working week," she said. Additional staff would also be required for a longer working day in hospitals, she said, adding that the staff ceiling in the health sector would have to be lifted.
The conference also voted in favour of introducing a system of competence assurance for doctors but rejected the current system which has been proposed by the Medical Council for auditing doctors to ensure they are competent and up to date. Prof Michael O'Keeffe, an eye specialist at the Mater Hospital, said under the system which had been proposed, some of a doctor's colleagues and patients, as well as his or her spouse, would be interviewed. It would not prevent another Shipman or Neary case, he claimed, and added that there were practical problems with it - how was a pathologist who only saw dead patients to be audited, for example, he wondered. "I believe this is Big Brother stuff. It smacks more of something that would come out of Stalinist Russia. There must be a simpler way of doing this," he said.
Delegates also unanimously rejected the new Medical Practitioners Bill in its current format. They were particularly worried it will result in a lay majority on the Medical Council and give "enormous" powers to the Minister of Health.