TÁNAISTE SIMON HARRIS has said the government expects everybody under a public-only contract to comply with the terms of their contract of employment. 

It emerged on Wednesday that the Rotunda Hospital has decided to allow consultants on public-only contracts do work for private patients.

Professor Sean Daly, the master of the Rotunda, told the Oireachtas health committee that the practice was being allowed to happen as there is no private maternity option for women to avail of in Ireland. 

“The only private care that is being allowed in the Rotunda for public-only contract holders is for pregnancy-related care, and that is because the Rotunda has long believed that women should have choice,” he said.

He told the committee that he did explain it to the Health Minister Jennifer Carroll MacNeill when she came to the Rotunda last year, adding: “Suffice to say, she wasn’t happy.”

Asked about the matter today during Leaders’ Questions, Harris said the minister for health and the government “expects that the agreed terms of any contract are applied fully and consistently across all hospitals”. 

Just because a person might be a higher paid member of the public service, that doesn’t mean they can “deviate” from contract. 

“If people have issues with a contract, that’s a different matter, but actually signing up to a contract and then not adhering to the terms of the contract is not a small matter,” he added. 

He told the Dáil that the Department of Health has written to the HSC chief executive on 18 March, setting out concerns regarding the continuation of private practice, and seeking full compliance with public-only consulting contracts. 

Social Democrats TD Padraig Rice said allowing public-only contract consultants provide private healthcare in maternity hospitals is completely at odds with Slaintecare, which he said is about creating universal healthcare based on need and not ability to pay, and removing private healthcare from public hospitals.

“How can we ever have a well-functioning and quality public health service if private practice continues to leach resources from the system,” he said. 

A statement from the minister for health to The Journal said she raised difficulties with any consultants on the public-only consultant contract continuing to treat private patients in the Rotunda when she met the Master recently.

It said she reiterated that private practice should not take place in public hospitals.

The statement went on to say that the Department of Health has also written to the HSE to clearly set out this position as they hold the service level agreement with the Rotunda.

“The contract represents a significant public investment and a clear commitment to a strengthened public-only system. The minister expects full adherence to these arrangements across the system

“While some consultants remain on legacy contracts that permit private practice, this does not apply to those on the public-only consultant contract,” said the statement.

The minister said a key objective of the contract is to “support equitable access to high-quality maternity care for all women and babies, regardless of their ability to pay, Its consistent implementation is central to that aim”.

What does private care include?

Previously, Professor Shane Higgins of the National Maternity Hospital predicted that under the roll-out of the public-only contract, private maternity care would be phased out over a period of five to 10 years. 

He told Newstalk in 2025 that currently, a majority of new mothers give birth on the public system, but a substantial minority opt for private healthcare. 

“In private, you actually choose your consultant; you look up the list of consultants offering private maternity care in the hospital, and you choose your consultant. 

“You enter into a contract with them where they will provide you with antenatal care and will do everything they can to be present at the birth of your baby. 

“If they are not there at the birth of your baby, another consultant will be there,” he said, setting out the terms of private care.