Public only consultant contract private practice: Clause 24

The POCC 2023 and the Limits on Private Practice

The Public Only Consultant Contract 2023 (POCC 2023) introduced strict boundaries on how medical consultants in Ireland manage their public commitments alongside their private work. Under this contract, any private practice must be scheduled entirely outside your public service commitment and must take place in off-site private facilities. For a busy specialist, such as a urologist managing public lists for transperineal prostate biopsies or flexible cystoscopy alongside a private practice, this split requires a clear administrative division. Navigating the public only consultant contract private practice limitations requires a clear understanding of where your public duties end and your private sessions begin. Because you can no longer utilize public hospital infrastructure, staff, or scheduling systems for private patients, you must establish an independent operational setup to avoid contract breaches. This division also affects how patient data is managed. If you practice across both sectors, you cannot rely on public hospital systems to store or access your private patient records. Maintaining separate clinical records is not just an administrative preference; it is a necessity under the contract's strict separation of public and private resources. Understanding how electronic health records in Ireland operate across these boundaries can help you structure your private record-keeping.

How Clause 24 Defines External Private Work

Clause 24 (External Work) of the POCC 2023 outlines the specific conditions under which a consultant can engage in private practice. The clause generally permits consultants to perform private practice in private facilities outside their public work schedule, but it places strict prohibitions on where and when this work can occur. According to the HSE's explanatory memorandum, Clause 24 prohibits the consultant from engaging in private practice during their public service commitment, or in public facilities, except with the explicit permission of the employer. The contract's stated policy is to phase out private care from public acute hospitals (Health Service Executive (National HR)). For your private rooms, this means that clinical sessions—whether they are prostate cancer follow-up pathways, hematuria triage, or vasectomy clinics—must be scheduled in dedicated private facilities such as the Beacon, Mater Private, Blackrock Clinic, or Hermitage Clinic.

Administrative Area	Public Commitment (POCC 2023)	External Private Practice (Clause 24)
Location	Public acute hospitals and HSE facilities.	Off-site private hospitals or independent consulting rooms.
Scheduling	Fixed public sessions and on-call rosters.	Strictly outside public service commitment hours.
Patient Billing	HSE salary; no direct patient or insurer billing.	Direct billing to open-market insurers or self-paying patients.
Clinical Records	HSE chart and public hospital electronic systems.	Independent private electronic record system.

When billing for procedures performed during your private sessions, your administrative staff must submit claims directly to the registered open-market insurers in Ireland, which include Irish Life Health, Laya Healthcare, Level Health, and Vhi Healthcare (The Health Insurance Authority). Under Clause 24, these billing records and schedules must remain entirely separate from public hospital administration.

Transition Rules and Appendix 9 Timelines

The transition from older consultant contracts to the POCC 2023 was governed by specific timelines outlined in Appendix 9 of the contract. These rules allowed consultants moving from earlier contracts—which permitted private practice within public acute hospitals—to maintain their existing arrangements for a limited transition period. According to the HSE's explanatory memorandum, the transition period was set until the end of 2025 for consultants who signed the new contract before the end of 2023 (Health Service Executive (National HR)). For consultants who signed after the end of 2023, the transition period was limited to six months. Because these transitional timelines have now concluded, any consultant operating under the POCC 2023 must be in full compliance with the complete separation of public and private practice. For those who transitioned, the public only consultant contract private practice became a distinct operational model, requiring entirely separate rooms, scheduling, and billing. If you are recording consultations or clinical dictations in your private rooms, you must ensure that your consent protocols and data storage meet the standards required for private practice. Reviewing the legal frameworks for recording clinical consultations can assist in aligning your private clinic's documentation processes with current standards.

Structuring Your Private Clinic Outside Public Hours

Operating a compliant private practice under Clause 24 requires an independent administrative infrastructure. Your private rooms must handle patient intake, scheduling, dictation, and billing without relying on the administrative staff or software of your public hospital. To manage this operational divide, many consultants utilize dedicated practice management software. Using a platform like Brigid allows your clinical secretary to coordinate schedules, manage clinic sessions across multiple private hospitals, and track patient billing. For urologists, this means clinical notes from a prostate pathway or stone follow-up can be dictated directly into the patient record, allowing your staff to review the transcript and prepare correspondence for your existing delivery channels. To reduce the administrative overhead on your secretary, the companion patient app, MyBrigid, allows patients to complete their intake forms online and settle their invoices via a secure payment link sent to their phone. This patient-first approach ensures that administrative tasks are completed before the patient arrives at your private rooms, reducing scheduling friction and helping you maintain a clear separation of your private session times from your public commitments.

Implementation Checklist for Clause 24 Compliance

• Schedule Audit: Document your public commitment hours and ensure all private consulting, diagnostic, and theatre sessions are scheduled outside these times.
• Infrastructure Separation: Verify that no public hospital IT systems, email addresses, or administrative staff are used to manage private patient appointments, letters, or billing.
• Independent Records: Secure an independent, EU-hosted practice management system to store all private clinical records and dictations.
• Insurer Registration: Ensure your private provider codes are active and aligned with your off-site private clinic addresses for Vhi, Laya, Irish Life Health, and Level Health.

Reviewing your current scheduling and administrative tools is a practical first step to ensure your private practice remains fully compliant with the requirements of Clause 24.

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