Maternity Care

The HSE threatened to trigger a process that could result in a funding cut to the maternity hospital unless it complied with its legal obligations under the service level agreement.

LAST UPDATE | 8 Jun

THE ROTUNDA MATERNITY Hospital in Dublin has agreed that its consultants on public-only contracts will no longer take on private care.

In a statement, it said: “The Board of Governors of the Rotunda Hospital met this evening and has unanimously decided to bring the hospital’s arrangements into line with the Government’s policy on the terms of the public only consultant contract.

“The threat of withdrawal of funding was something the Board could not countenance because of the potential consequences for women and babies,” the statement added.

It said the board continues to believe in the “importance of choice for women” and a compromise solution for maternity care “should be sought through dialogue with the Department of Health and the HSE”.

The contracts row has been ongoing for two weeks, with opposition parties urging Health Minister Jennifer Carroll MacNeill to meet with the board of the Rotunda Hospital to resolve the issue. 

The HSE threatened to trigger a process that could result in a funding cut to the maternity hospital unless it complied with its legal obligations under the service level agreement.

In a statement this evening, Carroll MacNeill welcomed the news from the hospital’s board.

“All of us, together, can now focus on continuing to deliver the very best care for all women and their babies and implement reforms that strengthen our public health service for  all,” MacNeill said.

Tánaiste Simon Harris praised Carroll MacNeill’s handling of the situation with the hospital, which he labelled a “bizarre situation”.

“You can’t have a situation where you sign on the dotted line and commit to doing public only and say, “Ah, should we do a vision private? I mean, that’s not fair,” Harris said.

Speaking earlier today, Public Expenditure Minister Jack Chambers said there would be “an escalation” if the Rotunda Hospital failed to provide the HSE with a list of public-only consultations who have been allowed to practice privately at the hospital by this evening.

The hospital was given until 5pm this evening to provide the HSE with a list of the names of each public consultant who was practicing privately in the hospital, as well as who granted permission for this and why.

The health service also sought the number of babies delivered by each consultant since 1 January, the number of expecting mothers currently under the private care of these consultants and the amount of money billed for and received by the Rotunda for these services so far this year.

Taoiseach Micheál Martin earlier said he was “very surprised” to hear that consultants signed up to public-only contracts have been providing private care in the Rotunda Maternity Hospital in Dublin. 

Speaking in Cork on Monday, Martin said “we can’t have a situation where the entire edifice which was negotiated between the representatives of consultants and the government, the last government, the then minister for health Stephen Donnelly, it was agreed, that that would somehow overnight and behind the scenes be undermined, is unacceptable”.

He said a number of consultants have not signed up to the public-only contract, and they can continue on with their private work. 

However, those consultants that have signed up will have to fulfil their contracts, said Martin, stating:

I think that is a very reasonable ask from government.

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 On Friday, the Rotunda requested a meeting with Carroll MacNeill to “explain the rationale” behind it allowing consultants on public-only contracts to see private patients.

But it emerged over the weekend that the health minister would not take part in any such meeting unless the Rotunda agrees to align with the agreement.

“If there isn’t compliance, then there’ll be an escalation under the service level agreement,” Chambers told RTÉ’s Today with David McCullagh this morning.

“This has been signed up by consultants in the Rotunda and many other hospitals to deliver better, more inclusive, accessible maternity care for women and babies,” he said.

“The Rotunda can’t have an à la carte approach when it comes to contracts that have been signed by doctors in their hospital, and also they should not be seeking to circumvent what they know is very clearly a public-only contract.

“That’s why we expect compliance and we expect implementation of the public-only consultant contract.”

Minister for Health Jennifer Carroll MacNeill. Alamy Stock Photo Alamy Stock Photo

Chambers said there was a very clear transition arrangement from 2023 to the end of 2025 which gave hospitals the space to reposition their wider work stream to deliver the public-only consultant contracts before it came into effect in January.

“We’ve had strong uptake of that by doctors and we can’t have cherry-picking of public contracts. This is a critical part of Sláintecare delivering a universal health system, and I support the minister in that regard.”

Labour’s health spokesperson Marie Sherlock said the “threats being traded” from the government and the health minister over the past week relating to the potential for funding to be withheld or withdrawn is “not right”. 

“I think we need the stand-off to end, and we have to have a conversation take place between the board of the Rotunda and the Minister for Health,” Sherlock told the same programme. 

She said public hospital facilities must be used for publicly provided maternity care, but said that on the other side, there is an issue in the detail in the public-only contract that must be resolved. 

She cited a clause in the contract, which says private work can be done only with the express approval of the employer – adding that whether the employer is the hospital or the HSE must be clarified.

“What I am saying very clearly now is that this needs to be fixed so that it’s not just about the Rotunda or indeed any other maternity unit, but indeed all hospitals that are publicly funded in this country.”

Social Democrats health spokesperson Pádraig Rice told RTÉ’s Morning Ireland said he welcomed the action that Carroll MacNeill had taken on the matter.

“The hospital has signed a service level agreement with the HSE and with the department. All these consultants have also signed these contracts, and they need to adhere to them, and we need to ensure that the reforms are delivered,” he said.

“Consultants are being very well paid to do public-only work in our public hospitals and I think they should do that. We cannot allow an individual hospital or an individual consultant to start to unpick the fundamental reforms for health service.”

Additional reporting by Andrew Walsh and Emma Hickey