'We had no choice’, Rotunda Hospital forced to drop private work for consultants

Vivienne Clarke

The Master of the Rotunda, Prof Sean Daly, has defended the board’s decision on private consultants at the maternity hospital, saying it was made based on legal advice.

Prof Daly was speaking on RTÉ Radio 1’s Today with David McCullagh following the board’s decision to comply with Minister for Health Jennifer Carroll MacNeill’s demand that public-only consultants at the Rotunda 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”.

It said the threat of withdrawal of funding was something the board could not countenance because of the potential consequences for women and babies.

The board’s decision in August 2024 was about women’s healthcare, but what was “absolutely clear” was that the “safety of all women is the same.”

Prof Daly explained that the contract that everybody who works in the Rotunda has is with the Rotunda Hospital.

Late in negotiations with the Department of Health, a clause, 2410, was inserted that gives an option for people “to request to offer a service.”

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. It had to review that request; it couldn't determine that request that was outside of what the hospital believed.”

In 2023, the masters of the three Dublin maternity hospitals approached the then Minister for Health, Stephen Donnelly, and requested that “obstetrics be looked at differently. And we had a very, very difficult meeting and got absolutely nowhere.”

“Our discussions fell totally on deaf ears.”

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.

“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.”

Daly pointed out that 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 women, Daly said that the Rotunda would ensure that the “right thing if 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.

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 it should have happened.  This issue is not going to go away.

“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.

“As I said before, this isn't an issue for today or tomorrow, certainly in the Rotunda, although it is an issue across many units in the country. But from the Rotunda's point of view, this will not become an issue for another eight or 10 years

“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 that if the hospital had sufficient midwives, they would be able to provide continuity of care for all women.

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