Older consultants may be exempt from 24-hour service

Healthcare reforms: The Tánaiste and Minister for Health, Mary Harney, has suggested that older hospital consultants be excluded from the new 24-hour service commitment envisaged as part of the Government's proposed healthcare reforms.

However, Ms Harney said younger consultants would be expected to work evenings, nights and weekends. She said that such requirements would be "the norm" and would form part of their contract of employment.

The Tánaiste did not specify what the cut-off age would be for consultants to be excluded from the new working hour requirement.

However, some senior medical sources said yesterday that the age of 55 had been mentioned previously in discussions over the Hanly report proposals in this area.

Speaking in the Dáil, Ms Harney also indicated that the Government could face significant compensation claims if it sought to change the existing contractual arrangement of the country's 2,000 public hospital consultants without agreement.

"Consultants have a contract of employment that lasts their working career. Either side can break or alter the contract, but there are serious financial implications if that is done," she said.

Ms Harney said the Government's proposed hospital reforms were aimed at providing a 24-hour, seven-day service delivered, rather than led, by consultants.

"There are 4,000 non-consultant hospital doctors and 2,000 consultants working in this country and we need to change that ratio around if we are to have consultant-delivered services. The commitment in the current contract is for 33 hours to public service work and we want to change that," she said.

The Department of Health and the Health Service Executive (HSE) has proposed a new contract under which consultants would work exclusively in the public sector as salaried employees. However, talks between health service management and medical organisations representing hospital consultants remain stalled.

The talks effectively broke down a month ago amid rows over the abolition of the category II consultant post by the HSE board and on how payment for working the new contract should be determined.

Hospital consultants are demanding that health service management suspend the decision to abolish the category II post until the conclusion of the talks process.

The category II contract allows consultants to see and treat fee-paying patients in private hospitals.

Consultants also want the issue of remuneration to be determined in direct negotiations with the HSE and the Department of Health.

The Government has proposed that if no direct agreement can be reached, that the issue should be determined by the review body which examines top-level pay in the public sector.

Government sources have indicated that the Tánaiste would have no difficulty in suspending the abolition of the category II post if it allowed full-

scale negotiations on the contract to progress. However, such a decision would have to be ratified by the HSE board which made the decision to abolish the post in the first place.

The HSE board was briefed by its senior negotiators on the talks at its monthly meeting last week. However, no decision was made to suspend the category II abolition. The chairman of the talks, barrister Mark Connaughton, is expected to meet the parties again this week.