Light at the end of the tunnel for consultant agreement?

The IHCA AGM and annual conference 2020 was full of familiar themes: Restoring pay parity for ‘new-entrant’ consultants; the health service’s deficits in staff and capacity; and physician burnout. But there is little that is familiar in this era of lockdowns and physical distancing.

You had to look no further than the format in which the annual conference was held to realise we are living in a new reality. Like so many organisations, the IHCA has had to adapt to physical distancing guidelines, with the conference taking place virtually. The IHCA, as well as the colleges and medical societies, should be commended for the way they have used technology to allow their meetings to go ahead in the most difficult of circumstances. Rarely has it been so important for doctors to come together to share their expertise and experiences.

Physician burnout was a problem before Covid-19. The pandemic has made the problem even worse, according to Dr Graham Billingham, Chief Medical Officer, MedPRo, Berkshire Hathaway. Speaking about the pandemic experience in the US, Dr Billingham told the conference the issue of burnout has been “exacerbated now, under the tremendous strain and long hours and clinical exhaustion”.

As has been said before, Covid-19 has highlighted weaknesses in healthcare systems and societies. In Ireland, our low consultant numbers and chronic capacity deficits, risk being ruthlessly exposed unless the virus’ spread is checked. A few days after the conference, which took place on Saturday 10 October, the Budget was announced. The Association welcomed the additional €4 billion that will be made available for the health service.

According to the IHCA President Prof Alan Irvine, this extra funding deserves to be “recognised and provides much needed backing at a crucial time”.

“Financial backing for beds at acute, community and intensive care levels is positive,” Prof Irvine said.

“Moving quickly to use this funding while in tandem providing transparency on bed delivery numbers at hospital level will give confidence to patients and healthcare professionals alike.”

At the conference, Minister for Health Stephen Donnelly committed
to ending the pay disparity for new-entrant consultants, who took up posts after 2012. The IHCA welcomed this commitment, but would be aware that Minister Donnelly’s predecessor made similar remarks.

On foot of recommendations from the de Buitléir report, the Government intends to introduce a Sláintecare ‘public-only’ consultant contract. While the pandemic delayed progress, the Programme for Government provides for the introduction of the contract. Recently, the Government approved the drafting of legislation to amend the FEMPI Acts to facilitate its introduction. The proposed amendments will enable serving consultants to switch to the Sláintecare contract, in addition to new consultants being recruited under the contract as recommended by the de Buitléir group.

The Government hopes the contract will be introduced early in 2021
following engagement with the representative bodies. Whether it will secure agreement is not certain given concerns the IHCA, as well as the IMO, have already expressed about the de Buitléir recommendations.

However, the IHCA’s positive response to the Budget announcement indicates, at least, a thawing of relations. The Association specifically commended Minister Donnelly for securing the additional healthcare resources.

Prof Irvine said addressing the health services’ deficit in consultant numbers is a “three-legged stool”: Namely, funding; enabling legislation to reverse the 2012 pay cut; and agreement.

“On all three, we are finally seeing a chink of light,” he said.

Given the darkness brought by the pandemic, chinks of light are in short supply these days and should be appreciated where they are found.