The Rotunda Hospital is in a stand-off with the HSE and the Minister for Health over a decision to allow consultants on public-only contracts do work for private patients.Prof Sean Daly, the master of the Rotunda, told the Oireachtas health committee on Wednesday that the practice was being allowed to happen as there is no private option for women in the maternity system in the State. He conceded that Minister for Health Jennifer Carroll MacNeill was “not happy” about the situation.“The only private care that is being allowed in the Rotunda for public-only contract holders is for pregnancy-related care, and that is because the Rotunda has long believed that women should have choice,” he said.Asked if Carroll MacNeill or the HSE were aware of the practice, Daly told the committee: “I did explain it to the Minister when she came to the Rotunda last year and suffice to say, she wasn’t happy.”Committee chair Pádraig Rice told The Irish Times the move from the Rotunda is “completely against stated policy”.“The public-only contract was a really significant change,” he said. “It was a long-negotiated contract. We cannot have individual hospitals unpicking that of their own accord without agreement with the HSE or Minister, in direct contravention of State policy." A spokeswoman for Carroll MacNeill confirmed she had raised the issue when she met the master of the hospital recently. The Minister had articulated her difficulty with any consultants on the Public Only Consultant Contract (POCC) continuing to treat private patients in the Rotunda. She reiterated that, under the POCC, private practice should not take place in public hospitals.The Department has also written to the HSE to set out this position, she said, adding that the contract represented a significant public investment and commitment to a strengthened public-only system.“The Minister expects full adherence to these arrangements across the system,” said the spokeswoman. “While some consultants remain on legacy contracts that permit private practice, this does not apply to those on the Public Only Consultant Contract.”She said a key objective of the contract is “to support equitable access to high-quality maternity care for all women and babies, regardless of their ability to pay. Its consistent implementation is central to that aim”.A spokeswoman for HSE Dublin and North East said the organisation was engaging with the Rotunda regarding the implementation of the contract and “the provision of private care at a public hospital”. She said “the HSE has clearly reiterated the policy position that private practice in public hospitals” is prohibited in line with the provisions of the public-only contract. Since 2023, consultants have been able to sign up to contracts committing them to doing only public work in public hospitals with basic pay ranging from €217,325 to €261,051. Any private work they do has to take place outside their rostered hours, away from the public facility. Rice has written to Carroll MacNeill in the wake of Wednesday’s committee meeting asking for further details on what the Department of Health and the HSE is doing to ensure the practice does not continue.