The board of the Rotunda has now said it will abide by national healthcare policy and ensure that consultants on public-only contracts are not breaching them by treating private patients. How confident is the Taoiseach that he can rely on what the board says? At the weekend, the Irish Independent revealed more concerning details of practices at the hospital. Consultants on public-only contracts who deliver babies for private patients at the weekend are routinely gifted with sums of up to €1,500 by consultants contracted to do that private work. The hospital is aware of this and described it as a long-standing practice. The hospital also says that the payment of these gifts is, “personal to the consultants and the hospital is not involved”. Given that women are giving birth in the Rotunda and are treated by consultants employed by the Rotunda, this is clearly nonsense. The hospital is very much involved. It just does not want to act.

Whistleblowers have informed my colleague, Deputy Pádraig Rice, that the payment of these gifts is not confined to the Rotunda. It is happening at Cork University Maternity Hospital, CUMH, too. It takes place at weekends because of the way the Rotunda and CUMH are operating their rosters. They each have just one roster while other hospitals are operating two, one for public patients and one for private patients.

Whistleblowers have also come forward to Deputy Rice about issues at University Hospital Galway. The hospital has a deal in place to do laboratory work for a private hospital and consultants on public-only contracts are being asked by management at the hospital to do laboratory work for private patients. While many consultants on public-only contracts are refusing to do this, it is nonetheless leading to big delays in the processing of samples for public patients. This includes public patients with cancer. As the Taoiseach knows, an early cancer diagnosis can save a life while a delayed diagnosis can be fatal. Delays are so bad at the hospital that it is outsourcing some laboratory work for both public and private patients to commercially run labs. This is at an enormous expense to the public purse.

Was the Taoiseach aware that some consultants in the Rotunda were receiving gifts of up to €1,500 to deliver a baby? Did he know that this was also happening in Cork University Maternity Hospital? Has Revenue started an investigation into these gifts, given that no tax is being paid? Is the Taoiseach concerned that this could give rise to a level of fraud if insurers are being billed for work consultants have not done? Was he aware of the issues at University Hospital Galway? Is he concerned that public patients are receiving-----

Thank you, Deputy.

-----delayed diagnoses for life-threatening conditions?

What actions will the Taoiseach take to address this?

First, the last Government moved in terms of negotiating the public-only consultant contract. We spent a lot of time and did a lot of work on it. We negotiated that with the IHCA. The Government not only expects that to be fulfilled, but will work relentlessly to ensure its enforcement and fulfilment. People cannot be signing contracts and then arbitrarily varying those contracts or deciding to ignore them. Neither can hospitals that are funded predominantly by the State do that either. It is an imperative that the public-only consultant contract is implemented and that it works as it is supposed to across the entire health service. Strong progress has been made in contract uptake and in increasing consultant capacity, but the clear focus now, on the Minister's behalf, the Department's and the HSE's, is on delivering in practice, particularly extended hours and weekend services for patients. More consultants are now rostered for evening and Saturday work, but the current levels remain too low and need to improve further.

We are fully committed, from the Government's side, to the implementation and enforcement of the public-only consultant contract. As I said, there has been strong national uptake - about 3,416 consultants had signed up as of 29 May of this year, including 1,220 new entrants and 2,196 consultants who have switched from the older contracts. This means that about 69% of all consultants working in our hospitals are now on the public-only consultant contract. Consultant numbers themselves have also increased significantly, with 51% more consultants now working in our hospitals than in 2020, strengthening overall capacity. The fundamental issue and the rationale for the contract is delivering stronger consultant presence on site, including at evening times and at weekends, so that the patients see the benefits of this contract.

As the Deputy knows, the contract allows for rostering from 8 a.m. to 10 p.m. Monday to Friday and 8 a.m. to 6 p.m. on Saturdays. At the moment, current figures show that only 37% of consultants are rostered for evening working and only 11% for Saturday. That is far too low and simply has to improve. The HSE has governance and programme structures to strengthen its oversight, reporting and accountability and the Minister is very clear about engaging with all of the hospitals to ensure compliance and implementation.

In terms of the Deputy's two questions, the answers are "No" and "No". I was not aware of what was contained in the report at the weekend in respect of gifts to consultants who turned up. Again, as the Deputy knows, Revenue is independent, but I am sure Revenue read the article, as the Deputy and I did. It is a matter for Revenue now to pursue any issues that arise from that.

Clearly, this is an issue beyond the Rotunda. There are instances in Cork and Galway. There is an emerging pattern around the country of breaches of the public-only contract. The Taoiseach and the Government have a responsibility to patients and to the taxpayer to ensure that the contract is being implemented. He is clearly not aware of the different breaches around the country. The Taoiseach, the Government and the Minister for Health need to get a grip on this. They need to get ahead on this. They need to take actions to ensure that the public-only contract is actually being implemented and enforced. What are the Taoiseach, the Minister for Health and the Government doing to ensure that the public-only contract is being adhered to? Is he going to get a grip or a handle on this? When are we going to see results in terms of ensuring that the public-only contracts are actually implemented?

First, the Deputy mentioned whistleblowers. I have not had access to those whistleblowers. I do not know whether they have formally given their information to the HSE or to the Department. Are they whistleblowers as per the Act or are they people who have gone to the Deputy directly? The Deputy might clarify that at a later stage; he does not have the opportunity now and I appreciate that. That is an important point. It needs to be clarified and the Deputy needs to be very transparent about that because I do not have access-----

The Taoiseach needs to be transparent about what he is doing to address this.

I do not have access to that information. What I can say to the Deputy, however, is that the Minister is extremely strong on this. The Government brought in this contract, which, in itself was a radical change from what had historically been the case. We are determined that it has an impact and an effect. As far as the Government is concerned - I was very clear last weekend in my statements on this, and the Minister likewise - we will not tolerate any variation from the contracts that people have signed up to.

What are you doing?

That will have to be implemented. I would like the Social Democrats to support that. They did the last time-----

Thank you, Taoiseach. The time is up. We move to the Labour Party's Deputy Bacik.