Martin Daly presses Rotunda over 'safety' claim withdrawal

Thanks everyone for coming in today. I just want to say from the outside, I have no ideological difficulty with private practice, I declare my own interest, I have a general practice and I have private practice, but I have a real attachment to the contractual obligations to service and to the state. And I'm going to come back, and again I want to make this absolutely clear, none of this is personal, but this is critically important in terms of the provision of publicly funded services to the citizens of this country. It's what we're talking about, we're not talking about the rights of anyone else, we're talking about the right of citizens and taxpayers to get value for their money and that contracts that are freely entered into are fulfilled. So I'm going to come back to the safety issue. Professor Daly, you were the one who raised the issue of safety at the last committee meeting. When you then talk about it being unconscionable about the fears that were raised around women making certain choices that go for private care, I mean, this is what you raised. It wasn't the media that raised this, it wasn't the committee that raised this, it wasn't the Minister for Health that raised this, you raised this and the Cohere Look asked you again, would you consider withdrawing that remark around safety, where there was a definite inference. Now everyone else can't be wrong on this, because everyone got the same inference. The inference was that women who had private care were receiving safer care than women who were getting public care. That was the inference. Now you have apologised for the use, but I'm asking you again, would you withdraw that? So I will absolutely withdraw it, because it has created a false impression. No, no, no, no. It's either you withdraw it because you withdraw it wholly, because it's not true, or it is true. Then I agree to withdraw it, because it isn't true. So then just again, the Cohere Look was very correct in asking you, and again this is what you said, it's not what the media has said, it's not what the committee has said or the Minister has said. You've said the fear of the board was that if there was a change in the way services operate heretofore, that the service would be less safe in the future. You have said that this morning again on two occasions. Do you withdraw that comment? Sorry, I think you've misinterpreted. No, no, no, no. Whatever you do, please do not accuse me of misinterpreting. I've been listening very carefully to you. I've read your statement very carefully. I've listened to the Cohere Look. I've listened to other members of the committee. You have said on a number of occasions this morning that the fear of the board was that the change in the way you operated heretofore to operating the POC contract would create a less safe service. You have said that. Would you withdraw that comment? Because that leads to engendering fear in women. That leads to people doubting the service, and as has been pointed out by Dr. Colm Henry here, we have, and yourself, we have one of the safest maternity services in the world. We might not have the nicest facilities at times. We may have at times deficiencies in the services. But overall, in a public health setting, we have a very safe service. So are you suggesting that the board, when it was making its deliberations and I want to come back to that, when it was making its deliberations to unpick what essentially was a pretty clear contract to most people, that you're suggesting you were doing that on the basis that a system going forward would be less safe because it would be in the hands of public-only contract holders? That was never the... So would you withdraw that comment? You've said it twice or three times. So I can't remember the exact words. Well, I remember because I've been listening carefully to what you're saying. Okay, I... So are you saying it's not the case? Are you saying that the service will maintain its quality no matter what contract, provided it's a good contract, which many consultants have signed into, that the service will be as safe going into the future? I would like to think it would be, but if you're asking me... That's entering a caveat. That's entering a caveat. If I could answer the question. Yeah. If I could answer the question. Yes, okay. So if you're asking me am I absolutely sure that a new system of care is as safe as the old system, I honestly don't know. Okay, that's fair. Because the new system hasn't occurred. Am I absolutely sure that if we resource healthcare and maternity care the way we would all like to see it resourced, that it will be safer? I am absolutely sure about that. That's a fair answer, and I understand that now completely. You say that the board of the Rotunda Hospital and yourself committed to slaughter care, but it would appear to me that you went to extraordinary lengths to unpick the public only contract. It was almost Jesuitical. You retained one of the biggest firms in the country in order to back up that thing. Now the interpretation is proven to be incorrect. So if you were committed to slaughter care and it's public only contract and they roll out of that, why did the board and yourself go to such extraordinary lengths to try and unpick that contract? Do you want to take that, John? I can take that, Deputy Lillian. Thank you for the question. I don't think the board ever tried to unpick the contract. Well, certainly, you know, there was a very definite attempt to reinterpret the terms of the public only contract and to find a way around it. That's a reality. I mean, don't take me for a fool. That's the reality. You retained one of the most expensive firm of lawyers in this country to back up that claim. Now you rolled up your tent after you were challenged on that. Because, in fact, that wasn't a true position contractually. I'm going to push this to Dr Cullum Henry again. Is that the position that that contract was that people, individual institutions could reinterpret the terms of the public only contract? Policy stated clearly, as was communicated by Anne-Marie Hoyt, and I might ask her to come in on this, that it applied to all consultants and HSE run and HSE funded facilities. Do you mind? Yeah. So just to restate that the policy, the standard care policy is really clear. The contract is also clear. There is no private practice on site in public health care facilities. And it's one of the key differences in the public only contract compared to the previous contract. And the correspondence that I issued and Dr Henry issued restates the provisions of the contract very clearly in that regard. Has there been an examination by the HSE of other maternity facilities in terms of how the new public only contract has been initiated and is operating? We've made very clear in the series of communications that the expectation is, that a requirement is, not just expectation, is that there is no payment or payment in kind for private work of public sites. You see, we've been told this morning that this type B contract and the new contract have been closely monitored. And yet we can't get figures. We're told we don't have figures. Do you have figures? On a wider point of view? It's been closely monitored. That's an oxymoron. If it's closely monitored, there should be audits, there should be figures. So it might be helpful, Deputy Daly, we have a verification or assurance exercise underway at the moment in relation to the cessation of private practice in public hospitals. So for those who have transitioned from the old contract, they had to cease. For those who are new starters, obviously, they wouldn't have that within their provision anyway. That exercise is well advanced at this stage and based on the returns that we have to date, there is no other non-compliance in maternity hospital that has been reported as yet. I would hope the verification exercise will be closed out this month. And I suppose just coming back, I have only a few seconds. Again, it's in the statement from the Rotunda that it's been a very difficult time. I want to pay tribute to the staff of the Rotunda Hospital for running a superb hospital, superb service, all levels of staff. But I know it's been a difficult time for the board. But it's not been a difficult time for the rest of the staff. They've got on with their work and done their work as they normally do, I would imagine. Thank you.