The master of the Rotunda Hospital has defended the board’s decision on allowing public-only consultants to do private work at the maternity hospital as having been made on the basis of legal advice.
Prof Seán Daly was speaking following the decision by the board of the Rotunda Hospital to acquiesce to the demand of Minister for Health Jennifer Carroll MacNeill that its public-only consultants take on no private work.
The board said in a statement on Monday evening that it has “unanimously decided to bring the hospital’s arrangements into line with the Government’s policy on the terms of the public-only consultant contract”.
The threat of withdrawal of funding was something the board could not countenance because of the potential consequences for women and babies, it said.
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Speaking on RTÉ Radio’s Today with David McCullagh show, Daly said the contract that everybody who works in the Rotunda Hospital has is with the hospital. Late in negotiations with the Department of Health, a clause was inserted that gives an option for people “to request to offer a service”, he said.
“The hospital has to deal with that request appropriately and we have had very strong legal advice from Arthur Cox that the board made the absolute right decision,” Daly said, adding it had to review that request and that it couldn’t make a determination on that request that was outside of what the hospital believed.
“In 2023 the masters of the three Dublin maternity hospitals approached then minister for health Stephen Donnelly and requested that “obstetrics was looked at differently. And we had a very, very difficult meeting and got absolutely nowhere.
“Our discussions fell totally on deaf ears.”
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Daly added that in special circumstances the management of the Rotunda can permit private practice on the grounds of the hospital.
“There’s been so much misinformation over the last week or two. I can guarantee you that every consultant in the Rotunda does their public hours,” Daly said.
“And then some do extra hours for their private patients under contracts which allow that, but nobody, nobody just does private practice in the Rotunda.
“The legal advice that we have is that we had to give due consideration. And the other aspect of this is that the hospital did believe that women should have choice.
“You know this was about women’s health, it was about women’s choice. I think the board made a decision in August 2024 and that decision was really about providing choice. What is absolutely clear though is that the safety of all women is the same.”
Daly said there had been only five deliveries up until the end of May by consultants on a public-only contract doing private work. When asked if money would be returned to those woman, Daly said the Rotunda would ensure that the “right thing is done by those women”.
There were a further eight women who have yet to deliver their babies who will be accommodated depending on what they want to do, he said.
In the Dáil on Tuesday, Taoiseach Micheál Martin said patients at the Rotunda who received private care from consultants on public only contracts should be refunded.
“This should not have happened in the first instance. These contracts were transparently signed up to by all concerned, including the hospital” with a service level agreement, he said.
Social Democrats leader Holly CairnsCairns said the Master of the Rotunda had said the hospital was breaching a public-only consultant contract by allowing consultants for “safety for women”.
“He hasn’t withdrawn that statement, but in an interview with David McCullough earlier, he attempted to clarify it. He said ‘nobody is saying it’s about safety’, even though that is literally what he said himself,” she said.
“He went on to say that having consultants treating private patients at the Rotunda improves safety for public patients, because if they happen to be around when a public patient needed consultant care, they could potentially pitch in.”
Cairns said the interview had left her in “complete disbelief”.
“Are we really saying that safety for public patients in maternity hospitals now depends on blind luck – that if they happen to be giving birth when a consultant is on site with a private patient, then they’ll be taken care of?”
She questioned whether that was “the type of two tier care that the head of our busiest maternity hospital in the country is fighting for”.
The board of the Rotunda had requested a meeting with the Minister for Health last week, but it was declined. “To be totally honest, I think [the meeting] should have happened. This issue is not going to go away,” Daly said during his interview.
“I think what we have seen over the past week or 10 days is that there is a lot of people who are very concerned about these issues, and these issues need to be addressed. And the board wanted to meet the Minister to explain their decision and to discuss how we might move forward.”
“At the end of the day, the Rotunda has always stood for women and babies. We have had a fairly significant threat that our funding would be cut.
“We deliver more than 6,000 public patients every year. We deliver the most complex patients in the country. We could never do anything that might affect that,” Daly said.
He said that if the hospital had sufficient midwives they would be able to provide continuity of care for all women.
