WHEN agreement was reached with consultants on a new contract, after years of tortuous negotiation, it was hailed as the dawn of a new era for the health service.
The aim was to reduce the ratio of private to public patients being treated by consultants, so that public patients would have a better chance of being seen sooner.
Many consultants received a big salary increase but could no longer charge a private fee no matter how many insured patients they treated. Many more received a smaller, but substantial, increase in return for confining the number of private patients they treated to a defined ratio.
Now, according to the HSE itself, as we report today, many consultants are not confining the number of their private patients to the agreed numbers. The HSE says that about 400, or one in four, consultants are in breach of their lucrative contracts by treating too many private patients.
For example, unnamed radiology consultants in one region are said to have a private workload of 45pc instead of their contractual limit of 30pc.
Why does this matter?
It undermines the principal aim of the contract, which was to improve the treatment of public patients while reducing the perception of a two-tier health service.
The consultants dispute the HSE figures and, not for the first time, communications breakdown may be a factor here, but the suspicion must be that the new contract is not realising its early promise of a vastly improved service for public patients.