Consultants and private patients


Sir, – Writing as a hospital doctor, I would commend the balanced analysis Martin Wall offers of consultants’ adherence to their contractual obligations (Analysis, March 18th).

However, he omits mention of one of the keystones of the relevant contracts. The Type B contract, under which the vast majority of us work, allows practice in co-located private hospitals once envisaged by then-minister for health Mary Harney. The idea was that since insured patients should be sent there once identified, there would be little reason to treat them in the public unit. This would free up hospital beds.

However, to date no such co-located private hospital has been built. Doctors are thus left with virtually no control over whom they treat, nor any capacity to alter the case mix of their hospitals. It simply reflects the throughput of emergency departments, and of GP referrals.

It remains a curious anomaly that the standard consultants contract refers to institutions that don’t exist, and are unlikely to ever do so, eg under Sláintecare. – Yours, etc,



Co Cork.