Just read this on RTE:
So I dont know much about this area but how did we end up in a situation where staff can see private clients in their employers workplace?
Just to be clear, they are not precluded from private practice entirely. Just precluded from private practice in the hospital where they are a public consultant. The issue for Dublin based obstetricians is very easy; they could simply practice privately in one of the other two maternity hospitals outside their 37 hour public contract!
You are missing the point; private maternity care can still be provided by these consultants, just not in the setting in which they have a public contract. A Rotubda public only consultant could practice privately in Holles St or the Coombe!
Would they be insured (and who pays the premium) in that case?
All insurance in the field of OBGYN (whether private or public) is paid for by the state at the moment.
The system is not fair while the public patient continues to subsidise the private patient.
I have no issue with your wife availing of a private birth in a private hospital at the full economic rate, which includes an indemnity on something going wrong. If, God forbid, your private consultant made a mistake, and your baby ended up disabled for life, who is on the hook for that? The private consultant? No. The taxpayer? Yes.
How is it subsidised by the tax payer, we are tax payers my wife was in a public hospital, supported by public stuff, in a public ward etc. Availing of what we are entitled to as tax payers with the extra cost mostly going towards the lead up to the birth and the attendance of our consultant at the birth. The majority of the care when in hospital during/after giving birth is under the public system as we were entitled to.
You simply want to force women to go through the public system and not be able to avail of the additional and very important supports available (to house who want/need them) by having a private consultant. Talking about a private only system is the came thing as saying you don’t want women to have the choice as firstly it’s unlikely to be made available privately and even if it was it would be unaffordable to most who are able to stretch to the additional cost at the moment. A fully private system is also likely to be inferior to the best of both worlds situation at the moment with the best of public care and expertise coupled with the addition of your own consultant
You and others who are arguing against the current system are championing inferior care and removal of choice from women.
So you are happy that you are able to afford private care under the current system for your wife, and you are happy to leave behind those who cannot afford private care under the current system, but if the system was changed to private hospital only, and you now joined the ranks of those unable to afford private care under a private system, you would feel that is unfair.
That is naked self-interest on display. The current system allows you to get healthcare at a level above others, whether or not they need it more, but if you don't like the idea of being left behind in future.
Understood.
The other consultants already have separately funded indemnity cover for their private work in the hospitals.
And that's perfectly fine, however if your doctor is working his public shift, there should be no possibility that you get preferential treatment. You ending up with at an entirely different doctor is perfectly fair in a public system.
The same? But it is not the same as everybody else, is it.
You want all the cream of the public services, but then you also want the consultants to drop all their other public patients and come to you privately when it suits you, all because you slipped them some cash. What is the "same" about that? Its literally two tier level of care within the same ward.
The level of self importance in your posts in this thread has been nauseating.
Wonder would you say that to the woman I was listening to in tears on the radio over this (just to pick one example)? Funny how this appears to be one of the last topics where removing choice and forcing (potentially) worse situations on women is tolerated.
I would love to see you or others go though a difficult pregnancy and come out saying all this stuff as the partner of the person who was pregnant since it is all men here arguing against this - you will go far and wide to find many women to agree that removing the choice of a private consultant is a positive thing.
This is not going to impact too many having children today as there is still choice to have private consultant (once you can get on their extremely busy books) and there will for many years but I am thinking of people in future, my own children or even those who are finding it hard to get a consultant to take them on due to the sheer volume of people wanting the sevices of a reducing number of consultants allowed to take on the work.
But this also has the potential to take away from the care of women who should take priority. So if you don't pay, you get potentially neglected by virtue of the paying customer. In spite of the fact the doctor is on a public shift.
Btw, you realise the minister who has chosen to pursue this is a woman? It's not a guy making this decision and it's based on the fact this is better for the overall quality of care of all patients, not just the ones who pay.
I have worked in both public and private sector jobs over the years and I have never had something in a contract to prohibit doing additional work - at most there was a cluse around clear conflict of interest/working for a compeditor. Throughout these jobs I have maintained self-employment part-time on the side and also done other contract evening work form time to time. This is far from uncommon in both public or private sector.
For example in healthcare you will find plenty of nurses who are full time HSE staff but also do a bit of work for private nursing homes or as agency nurses to make money when saving for a mortgage or just to bring in some extra cash, not uncommon for teachers to take on work such as private grids or private summer school/study classes - even working in construction etc.
If you were in a public sector job where the private work is occurring during your public shift that is an issue. And in this case it's a prominent problem. Btw, doing the above in the private sector or public would be considered to be a serious issue.
If the issue is insurance, then which hospital would ensure them in that case?
Are not all patients entitled to excellent care, or just the ones who can pay?
Do the consultants become less excellent at their jobs if they stop getting the wedge of money on the side?
BTW these consultants signed contracts which explicitly disallowed them doing what they are doing. Consultants on older contracts are still allowed. But signing a contract that pays you extra for your exclusive services and then having illicit work on the side is totally unprofessional and unethical
And yet Irish doctors emigrate because they can earn more in Dubai.
The reason we have a shortage of doctors in Ireland is because the medical profession restricts entry to the profession via a lower number of places in colleges than is required
We have 1,000s of students applying for medicine on the CAO each year. We have a budget surplus. We have good universities. This should be a very easy problem to solve.
We can and should be training enough doctors and consultants to ensure there are plenty for both public and private work. Ideally qualifying more than are needed to take account of any emigration and those who qualify academically, but are not suitable or change professions.
You'll find that many employers would have similiar in their code of ethics/behaviour etc
But Sections 14 and 16 in this has been implemented in the majority of Civil and Public sector contracts I'd think.
https://assets.oic.ie/media/283688/e14189cf-a24c-4baa-af3b-c4f72799d0f6.pdf
While it may be far from uncommon, it usually is against either an employment contract or some for of leglislation/code of ethics etc.
I can only guess the HR of the organisations you've worked with were unaware of their obligations under the variours parts of employment law/ leglislation in this country.
Hospitals have their own insurance and the government indemnity. Private consultants have to obtain cover up to a cap of (I think) nearly €2m. In nearly all obstetrics cases reported from court claims, the State pucks up the bulk of the cost. The purpose of the public only contract is not to stop them from doing private work but to not have them doing private and public work in the same hospital because of the conflict that arises. It’s not specifically related to obstetrics.
There's no income tax over there. Hardly a practical proposition for a developed country rather than a dictatorial microstate funded by oil and plenty of dodgy foreign money
And none of that is precluded; what is precluded is doing it in the premises where they have a public practice. I assume you did not carry out your additional duties on your employer’s premises using their tools. Likewise, most schools would not permit grinds to be given on school premises - insurance, safe guarding and other considerations.
There is a poster who appears to be arguing any additional work is not allowed for anyone which is more my response was directed - which of course is totally untrue for most people.
It not quite the same thing either though the point you are trying to make on a doctor doing his private work in a public premises as the patient is entitled public care and the doctor is on a shift in a public hospital, all the other staff assisting are public staff so I don't see why it's being considered "private work". They are not being paid privately for their shift - all the costs of the private care would be going into running the outside practice conducing scans and follow-up visits etc.
If a doctor was in his office writing code for a 3rd party during his shift that would obviously be very different to managing a case load to align with patients which in reality all that's happening.
This has been explained to you many times, paying so you're entitled to a specific doctor while he's working for the public system is not remotely balanced. You say it's for peace of mind etc but that still isn't remotely fair on patients who can't afford to do that. To use your own words, it's becomes a conflict of interests.
Women with a difficult pregnancy should get a high level of attentive care REGARDLESS of their fiscal means. To advocate for anything else is abhorrent.
You've made this point several times, but there's an explanatory memorandum of the POCC contract freely available which contradicts this assertion (screenshot below), so I'd be curious as to your source on this?
Similarly, discussion in a Dáil debate in Jan 2026 also went as far as to say POCC consultants were not permitted private practice in public hospitals:
"The Department of Health continues to implement the POCC in line with the Sláintecare vision. All consultants who switch to a POCC, regardless of specialty, are not permitted to conduct private practice in public hospitals beyond the conclusion of transitional arrangements stated within the terms of their contract. The HSE issued notice to all hospitals confirming this position in December 2025"
I am not advocating against it being available to everyone but being realistic it is very very hard to see the additional level of care and consultant time available by going private ever being available in a public system. Many people are just fine and happy in the public system also and only having their few scans and limited face to face time with a consultant so giving everyone all the extra visits wouldn't make sense either which is why having it as an option as it is now is beneficial.
If you feel that way you should have participated in the years long process that came up with SlainteCare which determine the new working modalities. The hospital consultants did, accepted and signed the contract and now some of them wish to break it without penalty.
That is very condescending of you to suggest that people are fine and happy with a lower standard of care than the one you can afford to pay for with your money.
You are trying to have it both ways, it is fine for the people without money now to put up with public care, but if private care gets more expensive and I move into that category it is not fine for me.
Sorry if it came across that way but that's not what I meant. When I wrote that I had in mind people I know who would be well able to afford private but they did not see any reason to go that route and were happy with the current offering in the public system.
I would also like to clarify we are not rolling in money, paying for private maternity was a significant expense for us and not just paid without a second thought.
