3412. Deputy Robert Troy asked the Minister for Health if she will provide clarity on the decision to remove access to private maternity services as part of Sláintecare; the details of the consultation which has taken place to date with relevant stakeholders in removing access to this service; if she will commit to further engagement with stakeholders such as an organisation (details supplied), clinicians, hospital boards and so on, to find a solution which provides a level of access to private maternity services for those who wish to avail of this route. [56243/26]

Public Only Consultant Contract (POCC) holders are not permitted to engage in private practice within public hospitals. This position is unequivocal: there are no exemptions, side arrangements or deviations from the terms of the contract. A key objective of the POCC is to support equitable access to high-quality care, including maternity care, based on clinical need and not ability to pay. Consistent implementation across all hospitals is central to that aim.

The Minister expects all hospitals and all consultants to be fully compliant with the terms of the contract. Where deviations have been identified, as occurred in the Rotunda Hospital, the Minister has been clear that the HSE must take immediate action to ensure full compliance. The Board of Governors of the Rotunda has accepted that the arrangements which allowed POCC consultants to undertake private activity in the hospital were wrong. The Board has confirmed that this practice has now ceased and that all POCC consultants are working in compliance with their contract. This is an important step because publicly funded hospitals must operate in line with agreed national policy and contractual arrangements, particularly where the objective is to deliver care based on clinical need and not ability to pay.

This is not about questioning women’s choices, it is about ensuring women never feel they need to pay to access better or more continuous care. The real choice in maternity care is not between public or private access, but rather how each women choses their care to be managed, in line with their clinical needs and best practice, including regarding the birth setting. A two-tier service can lead to continuity and access being unevenly provided, with practices of some consultants driving demand for private care instead of delivering the same level of high-quality care for all women in the public health service. The aim of POCC is to remove that imbalance and ensure equity of access, experience and outcomes for all women. Public hospitals are predominately funded by the taxpayer, and that funding must deliver the same high standard of care to every patient. The Government has made a significant investment in this reform, and it is essential that the benefits are now fully realised through proper and consistent implementation across all hospitals.

In maternity care, the core issue is not public versus private. It is ensuring that every woman has access to the same standard of safe, continuous, high-quality care as a matter of right. Many women choose private maternity care because they are seeking continuity, reassurance and access to a known clinician. Those are entirely reasonable expectations. The objective of reform is to ensure that those benefits are available to every woman in the public system, not only to those who can afford to pay.