Introduced by the Government in 2023, the POCC was designed to support universal healthcare objectives by gradually eliminating private practice within public hospitals. Consultants who sign the contract are eligible for up to €8,000 in funding to enhance patient care and improve services.
Last week, Professor Sean Daly, Master of the Rotunda Hospital, told the Oireachtas that consultants working under the POCC at the Rotunda had been permitted to deviate from the terms of their contracts due to the absence of a private maternity hospital option in Ireland.
While there are currently no private maternity hospitals in the country, approximately one in four maternity patients choose to receive private care.
The Rotunda Hospital, the largest maternity hospital in Northern Europe, delivers care to more than 10,000 babies annually. As a public hospital, it receives approximately 90% of its funding from the HSE.
Less than half of the Rotunda's consultants have signed the POCC, compared with the national average uptake rate of 67%.
In response, Minister for Health Jennifer Carroll MacNeill stated:
“They are being paid very good salaries to work in the public system, and we expect them to be there.”
She added:
“It would not be correct for any health minister to not push this in the way that is necessary.”
And emphasised:
“They have signed a contract.”
The Minister said she expects the hospital to operate in full compliance with Government policy.
The Rotunda board subsequently met to consider the risks and implications of the arrangement. In a statement, the board said:
“In all of its deliberations, the board’s overriding priority is to ensure that every patient receives the best possible care, regardless of whether they are a public or private service user.”
The board has now requested a meeting with the Minister in an effort to resolve the issue “for the good of all patients”.
The Minister has argued that maternity care presents a unique challenge because the State effectively underwrites both public and private maternity services due to the high cost of maternity insurance.
She stated that the issue would be less contentious if private providers were also able to carry the insurance burden themselves.
“The point of differentiation on this is if something goes wrong in maternity, at the moment it is only the state that can underpin the liability,” she said.
In correspondence with the Rotunda Hospital, the HSE indicated that it is considering a range of options, including the potential withholding of funding, should the hospital continue to operate outside the terms of the consultant contracts.
However, Minister Carroll MacNeill has assured the public that patient care will not be disrupted under any circumstances.
