Brennan Report - Department of Health and Children

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Report of the Commission on Financial Management and Control Systems in the Health ServiceAppendix 7EXTRACTS FROM THE CONSULTANTS’ COMMONCONTRACT 1Clinical Independence of Consultants (Contract - Section 5.2)5.2 Being a consultant involves continuing responsibility for investigation and for thetreatment of patients without supervision in professional matters by any other person. Thiscontinuing responsibility for investigation and for treatment of patients is a personal matterbetween each consultant and each patient in his care and it extends for as long as the patientremains in the consultant's care. The consultant may discharge this responsibility directly in apersonal relationship with his patient, or, in the exercise of his clinical judgement, he maydelegate aspects of the patient's care to other appropriate staff, or he may exerciseresponsibility concurrently with another doctor or doctors. Notwithstanding this however, theunique position of the consultant in the hospital requires that he carries the continuingresponsibility for his patients so long as they remain in his care.Responsibilities of Consultants (Contract - Section 6.2)6.2 As a consultant, your responsibilities will include, inter alia, responsibility for:(i)(ii)(iii)(iv)(v)(vi)producing a realistic agreed schedule which specifies how you intend to discharge inperson your full contractual commitment, over the period from Monday to Friday, takinginto account the exigencies of the service and the most effective utilisation of resources,supplying adequate advance notice in writing to hospital management advising them of allplanned absences, together with their duration,ensuring that fixed sessions, in particular Out Patient and Theatre sessions etc., shouldstart as scheduled in order to minimise delays for patients and possible disruption ofservices,providing management with rosters indicating clearly who will be on call and available tothe hospital at any given time where approved on-call/emergency services are to beprovided,agreeing with management the details of the service levels and mix to be providedwithin the scheduled commitment,supplying to (the employing authority) such information on the discharge of yourscheduled fixed and flexible sessions as is necessary and reasonable to establish that youare fulfiling your contractual commitment. The obligation to provide a schedule andinformation on the discharge of the scheduled commitment exists independently of theother provisions of this contract and accompanying Memorandum of Agreement,1The Consultants’ Common Contract is in two parts; (i) the Contract; and (ii) a Memorandum of Agreement180
Appendix 7(vii)(viii)(ix)participating, as of right in the selection process for Non-Consultant Hospital Doctors,and in the selection process for such other staff as the employing authorities agree areappropriate, in in-service teaching and training of medical and other staff, in researchwithin the hospital and in administration outside the management of your own particulardepartment or unit of the hospital,participating in a process of clinical audit, which will preserve the confidentiality of thedoctor/patient relationship,providing information to (the employing authority) including data for hospitalinformation systems and service planning and for such other purposes as (the employingauthority) and you agree are appropriate.Consultant Time Commitment (Memorandum of Agreement – Section 2.11)Scheduled Commitment2.11.1 The time commitment contracted by a consultant will be expressed in terms ofnotional three hour sessions.2.11.2 A consultant's time commitment, which will be personally discharged, will bescheduled in sessions during the hours normally worked within the Monday to Fridayworking week. The requirement to personally discharge all of the commitment doesnot preclude the consultant from delegating aspects of his scheduled work while thetime commitment to (the employing authority) is being personally dischargedelsewhere.Consultants in Management (Memorandum of Agreement – Section 6.6)6.6 Consultants in Management6.6.1 For hospitals to operate in an efficient and effective manner it is necessary thatdecisions affecting patient care are taken as near as possible to the point of servicedelivery. Consultants need to be involved in the management process. Thisinvolvement commences with the consultant's responsibility to manage his ownpractice and will involve co-operation with colleagues and other health professionals,at department, unit, hospital or hospital group level, extending to involvement in themanagement of the hospital/hospital grouping through direct membership orrepresentation on the hospital Executive Management Board.6.6.2 Each hospital or hospital grouping will have an Executive Management Board, theprecise constitution and role of which will depend on the structure and size of thehospital or hospital grouping. It is equally necessary that sub-Board structures are putin place to assist in the management process. The recent experience of the pilotprojects in a number of hospitals confirms that the concept of a distinct unit,grouping the clinical functions together under the leadership of a selected consultant(e.g. a Clinical Directorate model), represents an effective model to facilitate theparticipation of Hospital Consultants in the management process.181
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Commission onFinancial Managementan
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TABLE OF CONTENTSEXECUTIVE SUMMARY
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6.4 COMMUNITY DRUG SCHEMES 80Medica
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Executive SummaryEXECUTIVE SUMMARYT
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Executive SummaryWe do not underest
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Terms of ReferenceTERMS OF REFERENC
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GlossaryEstimates for Public Servic
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Chapter 1 Introduction and Backgrou
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Chapter 2 Overview and Issues2.2 OR
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Chapter 3 Managing the Health Servi
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Chapter 4 Service Planning, Budgeti
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Chapter 5 Accountability - Hospital
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Chapter 6 Accountability - General
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Chapter 7 Accountability - Employme
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Chapter 8 Audit ReformCHAPTER 8AUDI
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Chapter 8 Audit ReformRecommendatio
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Chapter 8 Audit Reformoutsourcing)
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Page 127 and 128: Appendix 1Appendix 1COMMISSION MEMB
Page 129 and 130: Appendix 1He has held this position
Page 131 and 132: Appendix 2SIPTU*South Eastern Healt
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Page 135 and 136: Appendix 3Name of AgencyIrish Blood
Page 137 and 138: Appendix 3Name of AgencyWomen’s H
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Page 141 and 142: Appendix 4collated and assessed by
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Page 153 and 154: Appendix 5Appendix 5DIAGNOSIS RELAT
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Page 157: Appendix 6Appendix 6AUDIT OF STRUCT
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Page 163 and 164: ADDENDUMNumber Recommendation IT Ti
Page 165 and 166: Number Recommendation IT TimeframeR
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Brennan Report - Department of Health and Children

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