The Government is to establish more than 80 new consultant posts in public health medicine over the next 2½ years as part of a proposed agreement on a new model of service which would aim to end a long-running dispute over contracts and pay issues.
Minister for Health Stephen Donnelly said on Thursday the new agreement would support the implementation of a fundamentally reformed public health model at a national and regional level which was aligned with international best practice.
The Irish Medical Organisation (IMO), which represents public health specialists, said the proposed "landmark agreement" had the potential to transform public health in this country.
Public health specialists, who have played a key role during the Covid-19 pandemic, voted to go on strike several months ago as part of a campaign for public health to become a consultant-led service, and for specialists in the field to be awarded consultant contracts “to reflect their expertise and specialist skills”.
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The proposed new deal was reached on Thursday after several weeks of talks between the IMO, the Department of Health and the HSE.
Strategic leadership
The Minister said the new model, to be introduced on a phased basis, would include the establishment of the grade of consultant in public health medicine to provide strategic leadership.
The Department of Health said “the enhanced service delivery model radically changes the governance and operating structure within public health, introducing a more fit-for-purpose national and regional management structure across each of the pillars of public health – a consultant led ‘hub-and-spoke’ structure as envisaged by the Crowe Horwath report”.
The proposed new agreement would see a consultant-delivered public health model implemented by December 2023, with the establishment of 34 consultant posts in the first year and a total of 84 consultant in public health medicine posts by the end of December 2023.
The Department of Health said that under the new model, consultants in public health medicine would “lead appropriately resourced multidisciplinary teams, that include surveillance scientists/epidemiologists, senior medical officers, trained contact tracers, administrative and, crucially, robust operations and management support”.
‘Strengthened’
Mr Donnelly said: “The Government has recognised that major reform of the public health function is necessary and through the Covid-19 path ahead plan we have committed to investing in, and resourcing of public health and the delivery of a strengthened and reformed consultant-delivered public health model. The past year has highlighted the critical national importance of a public health workforce with the capability to provide a robust and resilient health protection response.”
Public health specialists currently earn about €113,000. Hospital consultants with an existing type-A contract – which permits them to treat only public patients – have a pay scale that ranges from €141,026 to €195,653.
It is understood the proposed deal allows new consultants in public health medicine to move on to a higher-paid Sláintecare contract if this is put in place for senior doctors in hospitals in the future.
Dr Anne Dee, incoming chairwoman of the IMO's public health committee, said: "In terms of the development of public health in Ireland, this is a landmark agreement which has the potential to transform public health in this country. We will be recommending to our members that they accept this agreement. It is the culmination of a 20-year campaign to put Irish public health medicine on a par with the rest of the medical profession."
