Dáil Éireann Debate, Thursday - 27 September 2012
22. Deputy Derek Keating asked the Minister for Health the options in place to deal with the medical consultants pay and their unwillingness to support his plans; and if he will make a statement on the matter. [40792/12]
Amharc ar fhreagra28. Deputy Micheál Martin asked the Minister for Health if his Department was involved in the recent negotiations on the consultants contract; and if he will make a statement on the matter. [40092/12]
Amharc ar fhreagra33. Deputy John Halligan asked the Minister for Health the reason the issue of private practice was not on the table for negotiations with the consultants; and if he will make a statement on the matter. [41011/12]
Amharc ar fhreagra40. Deputy Michael McGrath asked the Minister for Health the amount the €200 million in savings expected from the agreement reached with the hospital consultants will contribute towards bridging the deficit in the health budget this year; when he expects to see the savings from this agreement; and if he will make a statement on the matter. [40965/12]
Amharc ar fhreagra52. Deputy Derek Keating asked the Minister for Health the options he has to deal with the position taken by the Irish Hospital Consultants Association (details supplied); if he will consider recommending to the Department of Finance the introduction of a super tax in such circumstances; and if he will make a statement on the matter. [40791/12]
Amharc ar fhreagra63. Deputy John McGuinness asked the Minister for Health if he will outline the terms agreed with consultants at the Labour Relations Commission; the aspects of the deal that have yet to be agreed; his views on whether these changes will begin from 1 October; and if he will make a statement on the matter. [40966/12]
Amharc ar fhreagraI propose to take Questions Nos. 22, 28, 33, 40, 52 and 63 together.
Following a request on 13 September by senior health service management on behalf of the Government, intensive discussions between health service employers and the two consultant representative bodies commenced immediately at the Labour Relations Commission and concluded on 17 September 2012. These dealt with a range of matters, including measures to ensure that the relevant parts of the Health Sectoral Agreement within the Public Service Agreement 2010-2014 can be given effect. The management team comprised officials from the HSE, my Department and the Department of Public Expenditure and Reform.
The outcome of this engagement is that detailed proposals have been agreed between the parties. Amongst the key provisions of this agreement are that:
- Consultants will be available for rostering for any five days out of seven as opposed to weekdays as at present;
- There can be rostering of consultants where required on a 16/7 (8 a.m. to midnight) or 24/7 basis in services where this is required;
- Clinical Directors will have a much strengthened management role in respect of consultants;
- Consultants will cooperate with a range of measures to support improved Community and Mental Health services;
- Consultants commit to expeditious processing and signing of claims for submission to private health insurers;
- There will be more cost-effective arrangements for funding of continuing medical education.
In addition, the proposals agreed include provisions regarding compliance with the contractual requirements regarding private practice These include a commitment by consultants to measures that ensure that public patients waiting for elective care of any type are seen within clinically appropriate timeframes and that the entirety of the Consultant’s private activity, including in-patient, day-patient and out-patient activity, is within contractual limits. Also, the parties agreed that the current methodology and process for private practice measurement will be accepted as a minimum base for the purpose of determining compliance with contractual commitments on private practice and the parties are committed to developing the system to include the appropriate range of clinical activity.
The agreement also puts on a formal basis consultants' co-operation with a range of productivity flexibilities, which will allow for considerable efficiencies in the use of hospital beds, with the potential to deliver a saving of 220,000 bed days annually. Given that these flexibilities are centred on enhancing productivity on an ongoing basis, they are not expected to deliver immediate monetary savings. A range of other measures are in train to address the current deficit.
Separately, Government will apply a 30% reduction in salary for future consultant appointees. Management proposals to reduce the “rest day” arrangements that currently apply and to eliminate the fee to consultant psychiatrists for giving a second opinion under the Mental Health Act 2001 will be referred to the Labour Court, in line with the procedures provided for in the Public Service Agreement. The issue of “historic rest days” will be referred to the Labour Court in line with normal procedures.
The medical representative organisations have agreed to present the agreed proposals on reforms to their members for consideration. I expect this to be done in a timely manner having regard to the relevant provisions in the Public Sector Agreement.
I believe that the proposals which have been agreed between the parties, when implemented, will allow for very significant reforms in how health services are delivered and ultimately will lead to improved outcomes for users of the services.
