Health Service Executive Verification Confirms End of Private Care Under Public-Only Contracts
Private healthcare delivered by consultants working under public-only contracts has ceased across Ireland’s public hospital system, a verification review by the Health Service Executive (HSE) has found. Mairéad Ryan of the national human resources office within the HSE stated that an initial verification exercise focused on compliance with clause 24 of the new agreements concluded that previously reported non-compliant service arrangements have been discontinued.
The review follows a dispute during the summer when Minister of State Jennifer Carroll MacNeill clashed with the board of the Rotunda Hospital in Dublin over consultants treating private patients while on public-only contracts. The Minister threatened the hospital’s funding and indemnity before the board backed down, prompting wider concerns among senior health officials regarding ongoing private practice across the wider health service.
Implementation of the Public-Only Consultant Contract
The public-only consultant contract (POCC) was introduced in 2023 as a key part of the Sláintecare reforms. Under the framework, senior doctors in hospitals receive higher salaries in exchange for eliminating their rights to treat fee-paying patients in public facilities. The previous contract allowed consultants to allocate up to 20 per cent of their public hospital workload to private practice, backed by a transitional two-year wind-down period.
While the majority of consultants have transitioned to the new terms, the elimination of private medical practice has created financial pressures. The HSE stated last month that the policy change has contributed to a projected income shortfall of nearly €145 million, largely driven by the loss of payments previously collected from health insurers for private patients treated in public hospitals.
Maternity Care Impacts and Political Scrutiny
The financial and operational fallout is particularly evident in maternity services. Because there are no private maternity hospitals, women are gradually losing the option of private maternity care within the State health system as the new contracts take full effect.
Social Democrats health spokesman Pádraig Rice called for rigorous management to ensure reform is not blocked by legacy culture, stating that authorities need concrete steps rather than simple assurances to guarantee nationwide compliance across every public hospital.
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