Talks about talks — the need to consult the consultants

Healthcare negotiations can often be a slow, laborious, affair. The consultant contract 2008 took over a decade of talks before it was finalised. Even getting to the negotiation table can be a hard and fraught process. The lack of engagement on a new GP contract is but one example. There is also the glacial progress on talks about the consultant recruitment and retention crisis, and specifically the reversal of the 2012 pay cut for new-entrant consultants.

One year ago, on 24 October 2018, the Taoiseach Leo Varadkar said it was important for discussions to commence on the issue with the IHCA and the IMO. Over the following six months, little happened.

At the IMO’s AGM at the end of the April, Minister for Health Simon Harris promised to establish a process to deal with new-entrant consultant pay. Again, over the following six months, progress was negligible.

It was only last month that the Minister wrote to the IMO to request that talks commence. He did not extend the invitation to the IHCA (although he did not rule out doing so at a later date), saying that the IMO’s affiliation with the Irish Congress of Trade Unions was the reason it was asked first. The Minister also linked the IHCA’s vote of ‘no confidence’ in him to the fact that it has not yet been asked to the table for negotiation. Relations between the IHCA and Minister Harris were not helped by the Minister cancelling his scheduled appearance at the Association’s recent annual conference for the second year running. Secretary General Mr Martin Varley said whereas the Association usually would meet with him twice annually, the union has only met with him once since its previous annual conference in October 2018.

At the IHCA’s recent appearance before the Joint Oireachtas Committee on Health, Fianna Fáil Health Spokesperson, Deputy Stephen Donnelly, asked delegates directly why they thought there was such “intransigence” on the part of the Government on failing to address the recruitment and retention crisis. For IHCA Vice President and Medical Independent columnist Dr Gabrielle Colleran, the reason was purely “ideological”. Mr Varley described the lack of engagement by the Minister as “inexplicable”.

There was also frustration expressed that there was no specific announcement or detail on consultant recruitment made as part of Budget 2020. While the Minister may have written to the IMO to start talks on the issue, the Organisation accused the Government “of not being serious about reform”, and doing nothing to stem the constant flow of younger doctors emigrating to other countries.

Aside from the current recruitment and retention crisis, there is also the prospect of a new ‘Sláintecare’ consultant contract, in line with recommendations in the de Buitléir report on the removal of private practice from public hospitals. Given the complexity of this task, and increasingly tense relationship between the medical representative bodies and health management, it is safe to say a new consultant contract is unlikely to be finalised any time soon.