NEW DIFFICULTIES have emerged in long-running talks aimed at securing a new contract for hospital consultants.
The Irish Hospital Consultants Association (IHCA) told health service management last night that its latest proposals were likely to be rejected by the association's national council at a meeting at the weekend.
It is understood the IHCA also told management that its council was likely to advise members to vote against a proposed new contract in any ballot.
Following two days of plenary talks this week, aimed at resolving outstanding issues on a new contract for hospital consultants, medical organisations are understood to be unhappy with management proposals in areas including private practice, hours of work and new arrangements for academic medicine in hospitals.
Both the IHCA and the Irish Medical Organisation, which also represents consultants, are to consider progress on the new contract at separate meetings tomorrow.
Informed sources said the medical organisations disagreed with management proposals that hospitals should have responsibility for billing private patients seen as out-patients in public facilities. The parties are also still apart on the level of private practice to be permitted in public hospitals in future.
It is understood medical organisations sought some relaxation of the current 80:20 ratio. This was on the basis consultants who would work in the new co-located private hospitals would have to pay their own medical indemnity subscriptions to see private patients there while they do not have to pay for such cover to see fee-paying patients in public hospitals at present.
Sources said the medical organisations had also contended management plans would decimate academic medicine and mean that medical professors would no longer necessarily be responsible for undergraduate education and training in hospitals.
Any rejection of the proposed contract by the IHCA would be a significant blow for Minister for Health Mary Harney as she had believed she had secured a deal with the organisation last January.
The introduction of a new contract for hospital consultants is a key element of the Government's overall healthcare reform plan.
Talks on such a new contract have now been under way for more than four years.
Health service management, meanwhile, has accused the medical organisations of seeking to push out the boundaries of proposals for a new contract brokered by an independent chairman, barrister Mark Connaughton, last October and again in February.
Gerard Barry of the HSE- Employers Agency said last night that while management had accepted Mr Connaughton's proposals in full, the unions had only done so with reservations.
Mr Barry said management had gone as far as it could with regard to the new contract without making it virtually indistinguishable from the existing contract.
Management has offered salary scales of up to €260,000 for consultants who opt to take the new contract. Management's proposed new contract would see consultants working as part of teams over an extended day and at weekends.
There would be greater regulation of private practice and new measures to ensure greater access for public patients.
Last week, Minister for Finance Brian Cowen, just after his election as leader of Fianna Fáil, expressed his frustration at the delays in agreeing a new consultants' contract. "We have been talking about reform and consultants' contracts for four years," he said.
"We have been asking them to please agree a contract which changes their working conditions, but provides us with many more consultants."