Minister Jack Chambers on how to speed up infrastructure delivery

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Today with David McCullagh 21 min 2 speakers 8 chapters transcribed 3 months ago
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What is the main focus of Minister Jack Chambers' discussion?

David McCullagh 0:00
Well, I'm also joined in studio by the Minister for Public Expenditure, Jack Chambers. Minister, good morning to you. Good morning, David. You're here to talk about other things, but we should talk about the Rotunda as well. There is a deadline of 5pm today. Your colleague, Jennifer Carroll-McNeill, wants the Rotunda to say it is aligning with government policy. What happens if they don't?
Jack Chambers 0:20
Well, if there isn't compliance, then there'll be an escalation under the service level agreement. I fully support the Minister for Health's work to drive reform and compliance around the public-only consultant contract. This has been signed up by consultants in the Rotunda and many other hospitals to deliver better public health care, to deliver better, more inclusive, accessible maternity care for women and babies. And the returning can't have an a la carte approach when it comes to contracts that have been signed by doctors in their hospital. And also they should not be seeking to circumvent what they know is very clearly a public only contract. And that's why we expect compliance and we expect implementation of the public only consultant contract.
David McCullagh 1:03
There is that point that Marie Sherlock was making there that clause 2410 of the contract does allow for some private work if it is approved by the employer. And it seems to come down to a legal interpretation of who is the employer. Is it the board of the Rotunda Hospital? Is it the HSE?
Jack Chambers 1:20
Well, I don't accept that wider point because, again, this is an attempt by the board and the management of the Rotunda to circumvent what's a very clear direction of public health policy, what's a very clear direction in terms of the service level agreement. Service level agreement is in return for public funding. There's compliance around the set of direction, the principles under which maternity care and health care is delivered within the hospital system. There was a very clear transition arrangement from 2023 to the end of 2025, which gave hospitals the space to reposition their wider work stream to deliver the public-only consultant contract. We've had strong uptake of that by doctors, and we can't have cherry-picking of public contracts.
Jack Chambers 2:07
This is a critical part of Sláinte care, delivering a universal health system, and I support the Minister in that regard.
David McCullagh 2:13
And she has the full backing of all the Cabinet.
Jack Chambers 2:15
Absolutely does.
David McCullagh 2:16
Was this discussed at Cabinet before she threatened to withdraw funding?
Jack Chambers 2:20
Well, look, we don't comment on what's discussed at Cabinet. I've discussed it with her myself. And what I would say is, though... But you can tell us what you discussed with hers, then. Well, I absolutely can.

How does compliance with public health policy affect maternity hospitals?

Jack Chambers 2:28
And, like, we're at one on... Like, we've constantly, like with Maria Sherlock there, again, referencing more funding. But myself and the Minister of Health are clear that the only way we're going to see... improved outputs in our health system is as much focus on reform and productivity. For example, in the public-only consultant contract, only 11% are rostered for Saturdays, only 37% are rostered for evenings. So the wider issue of compliance with the public-only consultant contract is critical to deliver a more efficient, productive public health system. And while it's not a case of constant discussion of everyone wanting more, how do we ensure that those who've signed up to the contract are working across the day.
Jack Chambers 3:07
And I acknowledge the work across many of the hospital groups in doing that. But we need to ensure that we've better implementation of the contract, including with the Rotunda Hospital.
David McCullagh 3:15
There has been an argument, as I'm sure you're well aware, there has been an argument from the maternity hospitals in particular, that they are a particular case for any other medical procedure or problem, there is a private option. There isn't in the case of maternity care because of the huge insurance costs involved. So is there an argument that in this one specific case there could be some flexibility.
Jack Chambers 3:42
There isn't because doctors here have signed up to a public only contract.

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