Threat over cut of Govt funding at Rotunda, says Master
The Master of the Rotunda Hospital has said that there was a fairly significant threat that Government funding would be cut over private practice by consultants on the public-only contract at the facility.
Professor Seán Daly said the issue related to one consultant and the hospital had wanted to meet the Minister for Health to discuss the matter.
Professor Daly was speaking after the hospital confirmed yesterday that consultants on public-only contracts will no longer treat private patients.
The Rotunda said the provision of private care allows access to more consultants and their presence on the labour ward is part of the reason the Rotunda is so safe.
The hospital said it has responded to the HSE request for information on private practice.
It is understood one consultant was involved in five deliveries privately and eight more women were due for private deliveries.
Today, Minister for Health Jennifer Carroll MacNeill said she did not believe consultants on the public-only contract at other hospitals were doing private work, based on information from private insurers.
In a statement, the Board of Governors of the hospital said that the threat of the withdrawal of funding was something it could not countenance because of the potential consequences for women and babies.
The country's largest maternity hospital and the Government had been in conflict over allowing consultants carry out private work despite signing a public-only contract three years ago.
Speaking on RTÉ's Today with David McCullagh, Prof Daly said that the contract that everybody who works in the Rotunda has is with the hospital.
He said that late in the negotiation process of contracts with the Department of Health, a clause was inserted by the department.
He said that this gave an option for a consultant to request to offer a service.
The hospital, Prof Daly said, then has to deal with the request appropriately. He said that they received "very strong legal advice" that the board of the hospital "made the absolute right decision".
He said that the request would then have to be reviewed and that the board could not make a determination on the request that was outside of what the hospital believed, which was that women should have choice.
"Back in 2023, the three masters of the Dublin maternity hospitals went to the Department of Health when Stephen Donnelly was health minister. They requested that obstetrics was looked at differently. And we had a very, very difficult meeting and got absolutely nowhere," he said.
"Our discussions fell totally on deaf ears."
Prof Daly said that the Rotunda Hospital has a contractual obligation to look at requests independently.
He said that in special circumstances, management can permit private practice on the grounds of the hospital.
He said that there had been so much misinformation over the last week or two. He also said that he could guarantee that all consultants in the Rotunda work their full public hours, while some do extra hours for their private patients.
"Nobody just does private practice in the Rotunda," he said.
Prof Daly said that the board wanted to met Minister Carroll MacNeill and explain its decision on rowing back from allowing consultants on the public-only contracts to do private work.
He said that the board also wanted to discuss with the minister how it might move forward.
Consultants on public contracts not providing private care - minister
Ms Carroll MacNeill said that she does not believe consultants on public-only contracts at other hospitals were doing private work, based on information from private insurers.
She added that insurance companies were "not flagging this to us as an issue in the way that they did with respect to the Rotunda".
Speaking to reporters on her way into a Cabinet meeting, she said: "We had told the Rotunda not once but twice not to do this."
She also said that she does not understand why the Rotunda Hospital continued to allow consultants on public-only contracts to treat patients privately.
"I do think that I'm getting a little frustrated with the narrative that the only safe care is private care," the minister said.
"It isn’t true of cancer treatment, it isn’t true of neurological treatment. Why is it that women should be told that they should be afraid?
"And if they’re not getting private care, and why is it that two women in the same hospital shouldn’t receive the same standard of care?"
All hospitals will have closely watched the outcome of the controversy involving the Rotunda Hospital and consultants on the public only contract doing private work.
The position of the Government was made starkly clear in recent days, that universal healthcare under Slaintecare means that private work must be separated from public work.
Today the Master of the Rotunda, Professor Sean Daly, said it was in the early stages of dealing with the issue and the Board had wanted to meet the Minister for Health to discuss it.
He has explained it involved one consultant who had delivered five babies privately and there are eight women who were also due to be treated privately.
It is expected these patients will now be accommodated in another way at the Rotunda, perhaps by transfer to a consultant there not on the public only consultant contract.
Prof Daly said there was a fairly significant threat that government funding would be cut, if the matter was not resolved.
The hospital was never going to take a risk that might affect patient safety, so it backed down last evening.
It has also provided the HSE with details of the private practice.
Minister for Health Jennifer Carroll MacNeill says her information is that this is not happening in other public hospitals.
She has also sought to dispel suggestions that private maternity care is the only safe care.
The Rotunda had taken legal advice on the clause in the Public Only Consultants Contract (POCC), which allows the option for the employer, to allow a consultant on the contract, to do private work, if the consultant requested this.
Legally the Board had to consider requests from consultants and it felt it had made a reasonable decision.
The Government took a very different view and it was a fight with too high a price for the Rotunda.
Because the Rotunda has other consultants who are not on the POCC, they can do private work, so the impact of all of this will not be seen at the hospital for many years, eight-10 according to the Master.
This is when the number of specialists on the old contract reduce due to retirement or replacement.
When the new National Maternity Hospital moves from Holles Street to be eventually built on the St Vincent's University Hospital campus, there will be no private wing in the facility.
But there will be some consultation rooms, where any remaining consultants who are not on the public only consultant contract, will be able to provide private care.
This too will reduce over time, as the number of legacy contract holders decline.
