Low levels of hospital consultants working into the evenings and on Saturdays is “really disappointing” with senior doctors expected to “remedy this” in July, Minister for Health Jennifer Carroll MacNeill has said.
Last week a report by Health Service Executive (HSE) internal auditors found that rostering of consultants to work during those hours, as permitted under the new public-only contract, remained low.
They found rostering arrangements broadly mirrored those in place for senior medical staff who operate under older non-public-only contracts.
Under the public-only contract – introduced in 2023 – consultants received higher salaries of €231,000-€277,000 before additional allowances or premium payments.
Also, as part of the contract, consultants can be asked to work between 8am and 10pm Monday to Friday and between 8am and 6pm on Saturdays as part of their overall core 37-hour week.
One goal of having more consultants working such shifts is to ease emergency department overcrowding caused by a delay in the discharge of patients from hospital beds.
The Sunday Times reported that Carroll MacNeill has given a deadline to begin working more evening and weekend shifts.
She was asked about the issue at a Fine Gael event to mark the centenary of the birth of Garret FitzGerald in UCD on Sunday and said there were four important aspects of the public-only consultant contract.
The first is not doing private work in public hospitals consultants on the contracts are working in, and the second is the increased salary “so that they’re doing public work and don’t need to necessarily subsidise it with private income”.
The other two are being rostered on evenings and Saturday; and that the consultants agree a work practice plan with the clinical director of the hospital and the regional clinical director on how they distribute their hours and work.
She said the work plan system began last June and went from 13 per cent compliance, when it comes to consultants uploading work practice plans last August, to about 80-90 per cent now.
However, referring to the results of the recent audit, Carroll MacNeil said “only about 12 per cent of consultants have in their work practice plan to work on Saturdays” and less than 40 per cent have included hours extended into weekday evenings “and most of that is between six and eight, not eight and 10”.
“To have such a low return on the work practice plans when it comes to extended hours and Saturdays is really disappointing,” she said.
The Minister said she has been working with HSE chief executive Anne O’Connor and “we cannot accept this outcome from the work practice plans being uploaded in this way”.
By July, she said, work practice plans would be expected to reflect the intended hours. She described this as a “reasonable period”.
“Someday the health service will work, fully, six days a week, and we will wonder how we ever worked in this [current] way,” she said.
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