Minister believes productivity increases and reform will save more in the long term, writes MARTIN WALL
SECURING REFORM and productivity increases from hospital consultants would be worth more to the health service than the benefits from reducing pay, according to the Minister for Health, James Reilly.
In answer to a parliamentary question, Mr Reilly gave his strongest indication that he was willing to trade the commitment to reduce consultant remuneration, as set out in the programme for government, for reform and changed work practices that could prove more lucrative in the long run.
He said that, while the programme for government provided for a reduction in pay for hospital consultants, his immediate priority was “to achieve more effective implementation of the existing contract so that patients get faster access to services and achieve better outcomes within the budgets available to hospitals”.
“I believe there is plenty of scope under the existing contract and the Croke Park agreement to achieve greater productivity from consultants. For example, increased consultant participation in patient discharges at weekends could more quickly free up beds for emergency admissions.”
Mr Reilly told Fianna Fáil’s Robert Troy in his written answer that the 2008 consultant contract provided for an extended working day, an increase in the length of the working week and structured weekend work, with consultants working as part of a team delivering the clinical directorate service plan and focusing on greater equity in the provision of care.
“The efficiencies, productivity increases and reform, if achieved, will be worth more to the health system than simply reducing the pay of consultants. I would strongly encourage consultants and their representative bodies to engage with the HSE and hospital management to progress this important agenda. The option of reducing consultant pay if these changes are not forthcoming is still very much available.”
Mr Reilly has said previously that about €100 million could be saved as a result of reforms and changed work practices, such as more consultant ward rounds at weekends to discharge patients earlier and improved access to diagnostics at those times.
The pay cuts envisaged for hospital consultants in the programme for government would be on top of the 15 per cent reduction in earnings put in place last year. Also, the previous government did not pay the second phase of increases due under the terms of the 2008 contract. The Government recently won a landmark test case brought by a consultant in relation to the non-payment of the increases.
Department of Health documents suggested the disputed amount could be up to €40,000 per consultant per annum from June 2009, and €30,000 back money in respect of the period up to June 2009 for type A contract holders. Consultants who signed type B contracts would be due lesser amounts.
There are about 2,000 hospital consultants covered by the new contract, so the State could have faced a bill of up to €100 million had it lost the case.