Folk should not be allowed to breach their contracts. That's all I'm saying on the actual controversy.
Nobody breached any contract. You'll note the Minister quickly switched from claiming the doctors had breached their contracts to making vague threats about Service Level Agreements.
A Consultant working fulltime will get paid around €350k to €500k a year.
The consultant salaries are published online. No consultant working fulltime on a public contract will get "€350,000 to 500,000" a year.
The POCC ranges from around €230k-285k per year. An additional €10k is paid to account for the fact we can be asked to do on call. We then have a bursary of approximately €36,000 per year for call-ins. In return we are only allowed to officially do 37 hours a week.
Clause 24.10 says that if our employer agrees, once we have fulfilled our 37 hours we can then pursue "external work" (external explicitly refers to work
external to the contract, not the site).
Please note the Government proposed and signed this contract. It reflects the EU directive which says an employer may not unreasonably restrict an employee from pursuing additional avenues of working outside their contract. If you have a problem with the terms of the contract then complain to the Department of Health who proposed, negotiated and signed this contract.
Contrast this to the "old contract", where consultants were paid between €180,000 and €230,000 but are allowed to pursue 20% private work either on or off site. There was an interim "O'Reilly" contract which paid between €120,000 to €170,000 approx but this was widely held to be a recession contract, not reflective of global market demand for consultants.
The State indemnity scheme is given
to a hospital. Any woman, whether public or private, will encounter many healthcare professionals who need indemnity. A midwife. A clerk. A HCA. A non consultant doctor. The consultant. A woman who has a negative outcome, whether public or private, is entitled to make a claim against the hospital responsible for their care.
For clarity, all women in the Irish healthcare system get a set standard of maternity care. It may look like this:
Booking visit (free, public, 12 weeks), Anomaly scan (free, public, 20 weeks), Antenatal clinic visit (free, public, variable timing), delivery (free, public, variable timing)
A woman may wish to get additional scans for reassurance. These are not clinically necessary. For this she would pay a consultant an
antenatal fee (€3000-10,000). In return she would get a private clinic visit every 4 weeks (12, 16, 20, 24, 28, 32, 36), a discussion how she might like to deliver (with the recent advent of maternal choice of caesarian section this is less important), and a commitment that the same consultant would attend her delivery.
The consultant attendance at delivery is paid for by the Private Medical Insurers (PMI) - around €500.
The maternity hospitals will not allow you private inpatient care if you are not booked with a consultant privately. That consists of a standard 3 night stay in a private room (not guaranteed), and slightly increased care provision (but realistically not clinically significant).
The fees that consultants charge privately are for the antenatal care visits. Once you make it to delivery the contract is fulfilled. To suggest the consultant is responsible for anything and everything that could potentially happen is silly, and you all would not tolerate a similar suggestion in your own careers
Mount Carmel failed because it couldn't compete with the maternity hospitals. Because the skillset remained there, carrying out public and private work, the calibre of healthcare staff at MC was poor, and outcomes were as such. Plus, it went bust when the country went bust.
It is entirely possible that a current private hospital could establish a private maternity wing - and now that the vacuum has been created, perhaps they will go ahead and do it.