THE MASTER OF the Rotunda has said it was “unconscionable” that women were “made to feel guilty or privileged” for seeking private maternity care.

The Rotunda Hospital had been involved in a stand-off with the government and HSE over its decision to allow consultants on public-only contracts to do work for private patients on the grounds of the Rotunda, which is not allowed. 

On 8 June, the Rotunda agreed that its consultants on public-only contracts would no longer take on private care.

Sean Daly, the master of the Rotunda, told the Oireachtas health committee in May that the practice was allowed to happen as there is no private maternity hospital option in Ireland.

He added that private care was allowed because the hospital has long believed that women should have a choice.

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

The move to consultants working on public-only contracts was a key provision of the Sláintecare healthcare reforms.

‘Choice’

Speaking at a health committee meeting this morning, Daly said that “nothing about a woman’s safe care has ever been predicated on whether she was public or private”.

He then posed “two larger questions to the committee”, the first of which was “choice”.

He noted that there is no private maternity hospital in Ireland and that women who choose private maternity care “will, over time, have nowhere in the system to go”.

Daly also pointed to resourcing, noting that Ireland has 3.85 obstetric and gynaecological consultants for every 100,000 women, compared to 5-6.5 across countries including England, Scotland, Canada, Australia, and New Zealand.

He said the past six weeks have been “particularly challenging” for the Rotunda and that the decision to allow private care “was not taken lightly” and followed 18-months of consultation.

Daly added that the board of the hospital was “was unaware” that private practice was not allowed by consultants on public-only contracts.

He said it had “not been detailed in the contract, and all employees of the Rotunda Hospital have Rotunda Hospital contracts”.

‘Unconscionable’

Daly then said that “what occurred over the past few weeks, where women were made feel guilty or privileged for having made certain decisions about their care, was unconscionable”.

Daly also claimed there were “many misconceptions propagated” in the media over the last number of weeks.

“I can assure the committee that there is no consultant working in the Rotunda who does not fulfil their commitments to the provision of public care before undertaking any care for private patients,” said Daly.

Daly also apologised for not being “adequately prepared for questions on the public only contract” during an Oireachtas Committee in May.

Back in May, Daly told the Oireachtas Committee that the decision to allow private care was “primarily about safety for women and women’s choice”.

Fianna Fáil senator Teresa Costello this morning asked is it was “unconscionable to suggest that women were getting less safe care when private practitioners weren’t on site”.

Daly replied that when he made these remarks in May, he was “not aware of questions related to the public only contract, and if I misled anybody by suggesting that there were safety issues, I apologise unreservedly for that”.

Costello repeatedly returned to the word “unconscionable” and said she retuned to the word because Daly had used this himself.

Daly said he used this term in “relation to a number of article in the media”.

“It was unconscionable that in the media women would be called out for having made those decisions,” said Daly.

“It was portrayed in the media that there were consultants who were just doing private practice in the Rotunda,” said Daly.

“I can assure you and the committee that that never happened.”

Elsewhere, Daly said the Board of the Rotunda had received “informal” legal advice on the issue and said the confusion arose because “the wording of the contract doesn’t suggest that the board, who are the employers, need to get any additional permissions to exercise the contract”.

He added that the Board “now accepts” the health minister’s “interpretation”.

Meanwhile, Sinn Féin’s health spokesperson David Cullinane called for a “very detailed breakdown from the Rotunda” in relation to money that was transferred for private care and asked “how were they getting paid for this”.

Vicky O’Dwyer, clinical director of the Rotunda, said the transfers were “all declared” and the Rotunda said it was “very happy” to provide a detailed breakdown of payments.