HSE asleep at the wheel on Public Only Consultant Contracts
HSE asleep at the wheel on Public Only Consultant Contracts - The Labour Party
- Audit shows POCC has failed to deliver significant increases in evening and weekend activity in public hospitals.
- HSE and Department of Health’s flawed approach exposed as audit finds key “enabling conditions” such as nursing staff, diagnostics, theatre access and support services have not been adequately addressed.
- Audit reveals alarming lack of national oversight and reporting on the operation of the POCC, three years after its introduction.
- Minister must clarify the impact of the €175 million Department of Health levy and HSE overspend on investment in hospital capacity and staffing.
Labour Health Spokesperson Marie Sherlock TD has called on the HSE and Minister for Health to urgently address serious gaps in the implementation of the Public Only Consultant Contract (POCC), following the publication of an internal audit report into its operation.
Deputy Sherlock said:
“I am deeply concerned that, three years after the introduction of the Public Only Consultant Contract, there is still no national reporting framework to monitor the elimination of private practice from public hospitals or to assess whether the contract is delivering greater public hospital activity.
“The rationale for removing private practice from public hospitals was clear: increase capacity and activity for public patients. Yet the audit shows that this has not materialised. Just 12% of public-only consultants were rostered for weekday evening work and only 11% for Saturday daytime work. Progress has been minimal despite the significant investment made in the contract.
“This audit exposes a fundamental flaw in the HSE and Department of Health’s approach. The POCC was never going to deliver improved productivity in isolation. Consultant contracts are only one piece of the puzzle.
“It is extraordinary that an internal audit has had to highlight what should have been obvious from the outset: extended rostering can only work when hospitals have the necessary nursing staff, diagnostic capacity, theatre access and support services in place.
“The HSE itself has acknowledged that almost 3,000 additional acute hospital beds will be required by 2031. We also face major deficits in critical infrastructure, including radiotherapy equipment, with some of our linear accelerator machines among the oldest in Europe and operating well beyond their intended lifespan.
“At the same time, hospital productivity continues to be undermined by the chronic shortage of step-down and community care capacity. For 79 of the last 93 days, more than 500 patients were delayed in hospital because they could not access appropriate care elsewhere.
“Against this backdrop, the Department of Health has been hit with a €175 million levy and the HSE is already facing significant financial overruns this year. The Minister for Health and the HSE CEO must now explain what impact these pressures will have on investment in the staffing, equipment and infrastructure needed to make the POCC work.
“The audit makes one thing clear: changing consultant contracts is not enough. Unless the Government is prepared to properly resource the wider hospital system, the promised benefits of the POCC will remain out of reach and patients will continue to pay the price.”