MORE THAN 1,000 consultants have signed the new public-only Sláintecare contract.

The Department of Health said it means that one in every four consultants working across the public health service is now on the new contract, with “hundreds” more applicants being processed by the HSE.

The 1,056 contracts include 241 new-entrant consultants who have joined the health service and 815 consultants who have switched from their previous contracts.

It comes after consultant and non-consultant hospital doctors expressed opposition to the new contract when it came into force earlier this year, with members of the Irish Medical Organisation (IMO) voting to reject it at the time.

Both organisations said there were not enough consultants to meet demand, with 73% of Irish Hospital Consultants Association (IHCA) respondents saying that they were “not confident that the new contract will address the Consultant recruitment and retention crisis”.

Under the new contract, consultants can be asked to work 8am to 10pm Monday to Friday and 8am to 6pm Saturday as part of their core 37-hour week.

The Department said that having an extended consultant presence on duty results in reduced emergency admissions, more rapid and appropriate decision-making, shorter lengths of stay, better patient flow and improved outcomes for patients.

The contract offers basic pay of €217,325 to €261,051 on a six-point scale, with additional remuneration for on-call duties and overtime. 

The Department said it offers more flexibility for consultants who want to work-share, do less than whole-time, work compressed hours or opt for different work patterns.

Minister for Health Stephen Donnelly said he was “delighted” with the response to the new contract.

“The introduction of this contract represents a landmark in delivering universal healthcare. It is a progressive contract that puts the interests of patients to the fore,” he said.

“This new contract is facilitating a transition away from the provision of private care in public hospitals and ensuring that state resources are provided in accordance with patient need rather than a patient’s ability to pay.

“The contract compares very favourably with other health services around the world and it is clearly proving attractive to potential candidates.”

There are 3,928 consultants working across the public health service, with 3,487 of these in permanent posts – an increase of 34% on 2019 levels.

HSE chief executive Bernard Gloster said: “It is a very significant development to have over a quarter of all consultants in the HSE now on the new contract, and this has happened over a short period of time.

“It is an important step towards enabling us to introduce reforms to our health system which will allow for enhanced care and greater out-of-hours and weekend presence of consultants in our hospitals, thus enhancing patient flow.

“This contract is helping us to operate in a highly competitive international employment market, enticing new entrants into the HSE.”

Move to seven-day service

In a statement to The Journal, a spokesperson for the IHCA said the final decision on whether or not to take-up the new contract has been a matter for individual consultants.

“As we have done throughout, the Irish Hospital Consultants Association will continue to support our members at home and abroad in this regard.”

The spokesperson said the IHCA appreciate the transparency with which Donnelly has shared the figures, but that transitioning those signing-up for the new contract into actual filled positions on the ground will be “the next critical challenge”.

“Ultimately, the real test will be the ability of this contract, together with the announced increases in hospital beds, theatre and other facilities which are urgently required, to address the 900 vacant consultant posts, the record number of patients on waiting lists and to make the Irish health service a place which attracts and retains consultants in order to improve the daily lives of our patients.”

Speaking on RTÉ’s This Week programme, Donnelly said the new contract is one of the measures his department is taking to move from a largely five-day a week hospital service to seven days.

“We know that a lot of health care professionals obviously are in the hospitals at the weekend, but in order to provide the best possible service for patients, in order to get rid of this scourge we’ve had for years of patients on trolleys, we do need to move to a seven day a week service,” he said.

“This contract is about patients. It’s about making sure that patients can get the care they need when they need it.”

He said it was “very positive” to see that over 1,000 consultants had signed up, adding that it was part of a long-awaited expansion in the number of consultants. 

“In 2019, we had about 2,600 consultants in permanent posts. We’ve gone from 2,600 to 3,500 and I’ve set a target that we get to 6,000 in the next seven years.”

HSE recruitment freeze

The Health Minister also said that he supports the HSE’s move to extend its recruitment freeze to almost all categories.

He said this year is the third year of record recruitment into the HSE in a row.

“The target for this year was 6,100. There were people who said we wouldn’t be able to reach that, it was a very ambitious target. The HSE now has either met that target in all of its categories, or in some cases slightly exceeded it,” he said.

“So what we’re saying now is we have fully filled or exceeded the number of funded posts and so there isn’t any more space for recruitment of those posts this year.”

The Irish Nurses and Midwives Organisation (INMO) has said it intends to engage with its members to consider taking industrial action in response to the freeze being extended.

The INMO also said that by its own calculations, there are currently around 2,800 nursing and midwifery funded vacancies in the health service “which urgently need to be filled”.

The organisation is calling for ”a meaningful implementation of the safe staffing framework that guarantees a minimum number of nurses and health care assistants per patient based on dependency and environment”. 

Asked about this, Donnelly said they are subject to the recruitment freeze for now.

“Any nursing posts that is involved in the safe staffing framework will be filled next year. There are several hundred of those around the country that still need to filled,” he said.

“This is the same as a school principal saying you can hire this many teachers. The principal hires that many teachers and then I think we all understand that they can’t hire any more teachers until they are funded.

“We will be rolling out next year safe staffing to all hospitals next year. We’ll be honouring all of the offers made to graduating student nurses and on top of that, we’ve gone to great lengths to protect a significant number of additional advanced nurse training places for next year as well.”

With reporting from Press Association