UP TO 100 senior doctors could be appointed as clinical directors to lead and plan services in the hospital sector under new structures unveiled yesterday by the Health Service Executive (HSE).
HSE chief executive Prof Brendan Drumm said that the plan would see one clinical director for every 40 or 50 consultants.
In larger hospitals there could be three or four such clinical directors, but in smaller hospitals the remit of such posts could spread over a number of sites.
In addition to the new post of national clinical director in the HSE, which was announced earlier in the summer, Prof Drumm said that he expected there would also be new positions of clinical leaders in the main speciality areas at national level. They would operate on a half-time basis - while retaining some of their clinical practices - for a number of years.
He said "there would also be a significant opportunity going forward for the development of clinical leadership posts in nursing and in the therapy areas".
Prof Drumm said the clinical directors, part of the new contract for hospital consultants, would be leaders and innovators in the management of services.
He said that for the first time there was the prospect "of significantly empowering clinicians as the key designers and leaders of modern health services".
"We know from experience that when care services have significant leadership from clinicians they deliver far better results," he said.
Prof Drumm said clinical directors would work across a number of areas, for example possibly covering accident and emergency, surgery, anaesthesia and intensive care.
This would ensure that a patient's journey was completed as efficiently as possible.
He said clinical directors would have a key role in planning the re-configuration of services in hospitals.
This would involve elective or non-urgent work being increasingly carried out in the smaller centres with the larger hospitals providing the more hi-tech services.
Each clinical directorate would be large enough "to justify comprehensive support by a business manager thereby empowering them to drive change".
Prof Drumm said that, over the next two years, clinical directorates would evolve on a staged basis with responsibilities gradually devolved to clinical directors.
An inaugural group of directors will be appointed for a two-year period and will play a key role in "the development of the clinical directorate structure," he said.
Prof Drumm said he expected "the large majority" of existing hospital consultants to sign the new contract, which was agreed earlier this year after four years of negotiations.
Yesterday marked the deadline for consultants to accept the new contract and receive the higher salary backdated to June.
Consultants who agree to take the new contract between September and the end of the year will receive the new salaries only from the time they sign the agreement. Under the new contract consultants will be paid between €175,000 and €240,000 per year. Doctors appointed as clinical directors will receive an additional €50,000.