HSE and hospital consultants reach deal

Agreement has been reached between health service management and hospital consultants on new work practices and flexibilities.

The Government believes the measures agreed after marathon overnight talks at the Labour Relations Commission could generate up to €200 million in savings for the health service.

Minister for Health James Reilly welcomed the agreement, which he said will allow for a series of major changes to the benefit of the health services and to the benefit of patients in particular.

"The consultants organisations have shown considerable leadership in agreeing to recommend these crucial changes," Dr Reilly said.

"The impact of what has been agreed has a vital financial benefit and, of greater importance, it paves the way for the more effective treatment of patients as we continue to reform our health services for the better in the interests of patients."

The Government has also decided to press ahead with the introduction of a new grade of hospital consultant, despite the objections of medical organisations. It is understood salary scales for the new consultant post will be significantly lower that the rates paid to those in existing consultant posts.

The salary scale will be between €116,000 and €121,000, said

the HSE's national director of industrial relations Barry O'Brien.

At present, hospital consultants’ salaries range from €147,000 to about €200,000.

Dr Reilly said while the consultant organisations have not agreed to the new pay scales, it is a matter for Government policy. “The decision has been made and the initiative will proceed,” he said.

Some elements of management's proposals, such as "historical leave" for consultants, is to go to the Labour Court. The court’s decision on historical leave will not be binding. Two other issues referred to the court include rest day entitlements and a €500 payment to psychiatrists for second opinions.

Agreement was reached between the parties on "complete roster flexibility", Mr O’Brien said on RTÉ Radio today.

Under the agreement, the HSE can roster consultants any five days of the seven-day week. Consultants also agreed to 24-hour rostering which is “fairly important” for changes in emergency department changes, he said.

"We’ll now be moving to roster consultants right across the working day which will give us greater decision-making and improve the level of consultants who will actually be on duty," Mr O’Brien said.

The role of clinical directors will also be enhanced and they will be "key leaders of change" in developing hospital groups, redeploying consultants and driving clinical outcomes, he said.

Talks between the health service management and hospital consultants continued overnight despite Dr Reilly setting a deadline of last night for the conclusion of the discussions.

Dr Reilly had said anything not agreed by last night at the Labour Relations Commission would be referred to the Labour Court for a binding ruling under the provisions of the Croke Park agreement.

In a document tabled at talks at the Labour Relations Commission, health service management proposed there would be "no differentiation between future appointees and existing consultants in terms of title, status or scope of practice".

Management said the fundamental features – other than salary – of the existing consultant contract, which was drawn up in 2008, would apply to new senior doctors recruited in future. However, management said some technical changes could be required.

Health service management also proposed significant reductions in the amount of historical leave arising from rest days that doctors could not take in the past. Management suggested historical leave could be reduced by half.

Under this arrangement, up to 450 consultants are entitled to take their last year off on full pay in lieu of overtime incurred in previous years.

Some consultants act as their own locum for that year. This means some senior doctors continue to do the same work but receive effectively double salary for that year.

The document estimated that, based on an average cost of employing one consultant at €230,000, historical leave could cost the state €103.5 million up to 2027, when the last group of eligible consultants is due to retire.

Management proposed the existing entitlement be halved and it be used before the end of 2018.