Rotunda facing questions amid phasing out of private care

Ireland's healthcare system is undergoing a significant transformation with the introduction of the Public Only Consultant Contract (POCC) in March 2023, signaling the end of private practice within public hospitals. Under this new contract, consultants who sign up can only undertake private work outside their main hospital and during their personal time. This contract is now the standard for new and replacement consultant positions funded by the Health Service Executive.

Over 67% of consultants have now signed the POCC, which adjusts salaries and requirements to reflect a greater commitment to the public system. The primary objective of this contract is to align with the policy of universal healthcare by phasing out private work in public facilities. For consultants who signed before December 2023, the transition deadline was the end of last year, after which they are prohibited from performing private work on public hospital grounds.

Specialists in maternity care are raising concerns that this policy shift could lead to the gradual disappearance of private maternity services in Ireland. Currently, approximately one in four women opt for private maternity care. The unique aspect of the Irish system is the absence of standalone private maternity hospitals; the Mount Carmel private maternity hospital, the only one of its kind, closed in 2014.

The Rotunda maternity hospital in Dublin has become a focal point of controversy. It is reportedly allowing some consultants, who are signatories to the POCC, to continue performing private work on its premises. Out of the Rotunda's 32 consultants, 14 have signed the POCC, though the number actively engaged in private practice at the hospital remains unknown. This situation positions the Rotunda as an outlier amidst a major government policy initiative aimed at strengthening public-only services.

Minister for Health Jennifer Carroll MacNeill has publicly stated her expectation for the Rotunda to confirm the cessation of this practice. She also suggested that women who paid for services on-site should be recompensed. The government's stance emphasizes adherence to the POCC to ensure a strengthened public-only healthcare service for all.