The Minister for Health has said that permission purportedly given to consultants on public-only contracts at the Rotunda Hospital that they could continue doing private work in the hospital must be rescinded.
Minister for Health Jennifer Carroll MacNeill said her “message” to the Rotunda is the same as she said it has been all along: “There is no provision for private work being carried out by consultants on the public-only consultant contract.”
Speaking on RTÉ’s Today with David McCullagh, the minister said: “It is a public-only consultant contract and there is no provision or permission to do private work by those consultants in a public facility such as the Rotunda.”
The minister said she was seeking confirmation from the Rotunda Hospital that it has “rescinded this practice for which they have no permission”.
Ms Carroll MacNeill said she also wanted details of the derogation that the Rotunda “purported to give to their consultants to do private work in the public system”.
“Who gave that permission, where is the written copy of that permission?
“And, also, in 2026 the women who paid private consultants to receive a private service in the Rotunda that the Rotunda was not contractually capable of giving.
“I think it’s important that those women are recompensed,” she said.
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The minister said that “the most important thing of all” was the “rescinding of any permission that was purported to be given to any consultants who are on the public-only consultant contract”.
Ireland’s busiest maternity hospital faces the threat of a funding cut if it does not reverse its decision to allow the consultants on public-only contracts to continue doing private work in the hospital.
The minister said that the Rotunda Hospital has 32 consultants, 14 of whom are on the public-only consultant contract.
She said: “That means that they’re being paid by the taxpayer to do public work for public patients.
“We fund the Rotunda, it’s 90% publicly-funded.
“We pay the salaries, we pay the heat, the light, all of the different things that you would expect in a publicly-funded hospital, and we expect the women there to be treated with equality.
“That is the situation and the Rotunda know this and knew this.”
The minister said she does not see how the Rotunda may have “misinterpreted” the directive “so far,” if that is what happened, saying: “This has been a very direct conversation with the Rotunda.”
Ms Carroll MacNeill said she does not know how many of the 14 consultants who are on the public-only consultant contract are doing private work, and the Rotunda has been asked to provide this information by next Monday.
She added that the hospital could have given the information any time this week, but said she “thinks” the number is “low, but in any event there is no permission for that”.
Minister said she warned Rotunda multiple times about issue
The minister said she told the Master of the Rotunda Seán Daly a year ago during a private meeting when she was touring the hospital that consultants under the public-only consultant contract doing private work was “not on”.
“And then I assumed that in telling him that, that he, you know, heard what I said,” she added.
She said 70% of consultants have signed up to the public-only consultants contact since it was agreed in 2023 “which is a hugely significant reform in the health system”.
“But the transition period where it was to come fully into force with absolutely no private work being done by those consultants in those hospitals was the end of 2025.
“So the really important period for this conversation is 2026.”
Minister Carroll MacNeill said she told the Master of the Rotunda again during a meeting about the hospital on the 18 March that “this is still an issue”.
“Can you just make sure that it’s fixed, make sure that it ends, that’s all there is to it?” the minister said she told Mr Daly.
“I have mentioned it at the Cabinet sub-committee on health, and we followed that up with a letter from the Department [of Health] and the HSE.
“So it was something of a surprise to hear the Master [of the Rotunda] go into the Oireachtas Health Committee to say that he has not in fact finished that practice, make sure that it is ended, but in fact is continuing it,” she said.
‘Demand and wish is there’ for private care – Holles Street Master
Master of the National Maternity Hospital, Holles Street, Professor Jennifer Walsh said she believed it is “really important that this coversation started again around maternal choice”.
She told the same programme: “And I do believe it is around maternal choice. I’m really keen that this is a conversation and it isn’t a battle.”
Prof Walsh said why people want private care is a “much broader topic” and “one we don’t like to talk about”.
She said that the “reality” is that 40% of the Irish population has private health insurance and in the National Maternity Hospital, “39.2% of our patients choose to use that (private cover) for maternity care”.
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Prof Walsh said: “So that demand and that wish is there.
“Why it’s there is a whole other question and I don’t think it’s my place or anyone’s place to ask women why they choose that pathway.”
Prof Walsh said she could “speculate” about the reasons, but that “in no other facet of healthcare, if people are getting their hips or their knees or their cardiac care or their prostate done privately, nobody is subjecting that decision to any scrutiny”.
“But our women are being scrutinised as to why they are choosing this pathway of care.
“And in some areas of the media, they’re being judged for that decision, I think that’s unfair,” she said.