Public-only hospital contract: Here’s everything you need to know about it

by Mariam Maroof

In late 2022, the government made way for a new consultant contract that challenged the healthcare system of Ireland. The proposed new contract came at a particularly problematic time for the Irish healthcare sector. With s shortage of beds, increasing number of patients, lack of doctors and ruthless working hours, the public-only hospital consultant contract is what is needed to revive the system.

The need for reform

The country’s healthcare system has long been a cause for concern. Following the COVID-19 pandemic and with the influx of refugees, the number of people needing medical services has vastly increased. Among the several issues that pertain within the system, one of the most striking issues is that of recruitment and retention. With over 900 consultant positions waiting to be filled, the public healthcare services are simply unable to provide timely assistance.

According to a report by the DoH, the government has prioritised a public healthcare system whose services are delivered largely by consultants. Consultants’ ability to make quick-decisions that best suit the needs of patients, after years of on-field experience allows for lower emergency admissions, shorter stays in the hospital and better post-discharge care plans.

Because of this, the focus of the contract, which came into effect in March, lies on work being done in public hospitals that aids in building a system where all patients of public hospitals are dealt with in accordance with their needs.

What does the contract entail?

The landmark move, introduced in a collaborative effort by the Department of Health, the Health Service Executive, the Irish Medical Organization, and the Irish Hospital Consultants Association aims to rectify overhaul the Irish healthcare system.


  • Consultants will be offered a basic pay of €209,915 – €252,150
  • They will also be receive added bonuses for duties performed on-call and overtime.


  • Under the new contract, consultants will work a 37-hour week.
  • Their contracted hours will be 8am to 10pm from Mondays to Fridays, and 8am to 6pm on Saturdays.

Additional benefits

  • Having fulfilled their public practice contract, consultant may practice privately.
  • Flexible contracts will permit consultants to enjoy varying work patterns such as work sharing, compressed hours, and flexible start and finish times.
  • Consultants will be encouraged to partake in further medical training and research.

The backlash

While the contract comes through a collaborative effort through several meetings and discussions, a striking percentage of consultants opposed the idea of the public-only hospital consultant contract.

The contract faced backlash from a majority of members from the IMO and the IHCA, who voted to reject the contract. The DoH, however, are confident about the efficiency and the results the new contract will bring in.

As many as 57% of consultants in the IMO have announced that they would not switch over to the new contract. This reveals the lack of faith that consultants have in the new the contract. According to an internal survey carried out by the IHCA, 73% of public contract respondents claimed that they weren’t confident that the contract would address the consultant recruitment and retention crisis.”

According to, a representative from the IHCA said: “While the employer has moved to talk-up its significance, those of us grappling with the system day-to-day can be forgiven for having reservations. The reality is that there are simply not enough consultants to meet the increasing demands. We are working with 40% less consultants in Ireland compared to the EU average.”

Like most initiatives, the public-only hospital contract is one that has been announced in good faith. The efficiency or lack of will only become known in the future. Having invested over €23 billion in the health budget, the new contract serves to be among the many efforts being put into reviving the Irish healthcare system.

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