Reilly favours work reforms before pay cuts for consultants

LONG-PLANNED talks on new work practice reforms for hospital consultants are set to get under way tomorrow.

Department of Health and HSE officials are to meet representatives of the Irish Hospital Consultants Association and the Irish Medical Organisation in what is expected to be the start of an ongoing process.

Initially the talks are likely to centre on proposals for hospital consultants drawn up by health service management earlier this year under the provisions of the Croke Park agreement.

The programme for government drawn up last year between Fine Gael and Labour contained a commitment to reduce the pay of hospital consultants, who are the largest group of high-earners in the public service.

However, Minister for Health James Reilly has instead signalled that he would prefer to see the introduction of revised work practice changes, which, he argues, could generate larger savings rather than further pay cuts for consultants.

Another complicating factor in cutting pay is that both the Irish Hospital Consultants Association and the Irish Medical Organisation have signed up to the Croke Park agreement, which protects pay for public service staff in return for co-operation with reform.

Last week Dr Reilly said that voluntary reforms undertaken by some consultants, such as carrying out ward rounds and reading patient diagnostics and other reports at weekends to facilitate early discharge, had produced savings of 70,000 bed days worth €63 million.

He said there was a target of generating savings of 100,000 bed days this year.

Consultant sources said when the talks commenced they were likely to seek clarification on the status of the proposals for change under the Croke Park agreement, which were drawn up by management without consultation with the staff side earlier this year.

The health service action plan under the Croke Park agreement contains some of the most radical proposals put forward across the public service.

For hospital consultants, as well as for nurses and other healthcare staff, it would involve significant change.

It suggests some consultants could be rostered on any five out of seven days, a major reform as at present they are contractually entitled to extra payments for weekend work.

Consultants would also have to co-operate with measures to achieve greater collection of income for public hospitals from insurance companies – the HSE has argued millions are outstanding due to delays in doctors signing forms. Consultants would also have to support the introduction of advance nurse practitioners, and be compliant with private practice limits as calculated by a currently disputed measurement system.

Controversially, consultants would be obliged to agree to the existing HSE methodology for calculating private practice rates, a system which has been strongly challenged by their representative bodies over recent years.