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Consultants Private Practice
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I was listening to Pat Kenny this morning where there was an interview with Gerard Barry (HSE Employer Manager Morning Ireland had him aswell) on all this Consultant contracts malarky.
The essential point being made by him is that the current system of ‘double jobbing’ has to stop and the contract is as much about creating a fidelity to public practice among consultants. The new contract demands full discharge of public service obligations before treating private patients.
As structural reform goes it seems to be quite necessary. The gap between public and private patients appears to be growing. The saga of Rosie over the past few weeks has underlined the case that redrawing the line between public and private service is a matter of urgency.
While the consultant contract is a major issue in this area it needs to be part of a wider appraisal of the role and reliance on the private in the health system. That private needs to be accomodated is at present part of the consensus among negotiaters and recognises how deep those roots go in the institutions. Perhaps there is an aspect of this I am missing out on but this seems to be an effort at getting money to the front line (i.e. consultants) and commiting delivery to public patients.
The consultants contract could become tangential however unless the public sector is reaffirmed further and the dividing line pushed back.
This all goes back to a core problem for me with much of what passes for private enterprise in Ireland, in effect it is the provision of a public subsidy for private gain. I have no problem with those who wish to be in private practice doing so. However, they need to do it without the safety net of the public picking up the tab for all the big ticket items like buildings and equipment. I doubt that many of those who are doing well out of the mix and match set up at present would be doing quite so well if they had to build their own hospitals in prime sites and had to convince a bank to lend them the cash to do so.
If they want to be entrepenuers then they need to take some risk in order to be able to claim they deserve the rewards.