Are the IMO deluded?

nice_guy80 · 01-11-2014 12:45am #1

Doctors who are members of the Irish Medical Organisation (IMO) have voted overwhelmingly to reject revised pay rates for newly-appointed hospital consultants which ranged from €125,000 to €175,000.

The proposals, which were brokered at the Labour Relations Commission in September, also allowed for consultants with experience abroad to enter the Irish public hospital system at a salary level of up to €155,000 rather than at the starting point on the scale.

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The IMO seem to be very eager to maintain the tight stranglehold that they have on the medical profession in Ireland.

how could a salary from €125,000 - €175,000 not be considered a good salary?

between the doctors and lawyers it is no wonder the country is still borrowing €5 billion a year

My name is URL · 01-11-2014 1:23am

nice_guy80 wrote: »

how could a salary from €125,000 - €175,000 not be considered a good salary?

You'd have to ask all the consultants that choose to work elsewhere.

Sand · 01-11-2014 1:47pm

The ones that work elsewhere have managed to secure a job elsewhere against the competition they faced for that role, with an employer that can afford to pay. The L'Oreal consultants here will have to make do with what we can afford to pay.

My name is URL · 01-11-2014 6:00pm

Sand wrote: »

The ones that work elsewhere have managed to secure a job elsewhere against the competition they faced for that role, with an employer that can afford to pay. The L'Oreal consultants here will have to make do with what we can afford to pay.

Plenty opting to work abroad for far less money too though. Working conditions, cost of living differences and quality of life all come into it.

It's not all about bigger salaries.

The Corinthian · 03-11-2014 10:36am

My name is URL wrote: »

It's not all about bigger salaries.

I agree and also not. Tax, cost of living, salary levels, infrastructure all add up to quality of life, so it's not all about salary. But when you have a country like Ireland where cost of living is relatively high, as is tax (when you consider indirect taxes), public transport is a joke, child care expensive, and so on, then increased salary is how you compensate people and get them to work in a 'hardship post'.

FreudianSlippers · 03-11-2014 12:58pm

It's not a great salary for the level of education and skill. It's also not great when compared to other countries. I'm not even going to touch your silly comment about lawyers. :rolleyes:

Sand · 03-11-2014 9:17pm

My name is URL wrote: »

Plenty opting to work abroad for far less money too though. Working conditions, cost of living differences and quality of life all come into it.

It's not all about bigger salaries.

The key thing is Ireland pays what it can afford. As a country living hand to mouth, reliant on the kindness of strangers and trying to shove spending off balance sheet wherever possible (i.e. Irish water) that is not much at all.

Talking about what people can make in other countries is nice, but not relevant. Ireland is paying what it can afford. Other countries can pay more, and they will *maybe* get more (the Irish record is pay more with no actual benefit detected). If Irish consultants really are all that, then by all means they should go abroad, compete for those roles and successfully get them. I wish them the best of luck.

Meanwhile, Ireland should only pay what it can afford.

The Irish public sector has a long habit of benchmarking its pay and benefits to best in the world levels. It is long overdue that the only important benchmark is applied: what Ireland can afford.

nice_guy80 · 03-11-2014 10:00pm

FreudianSlippers wrote: »

It's not a great salary for the level of education and skill. It's also not great when compared to other countries. I'm not even going to touch your silly comment about lawyers. :rolleyes:

why not?
the cost of hiring legal help in Ireland is extortionate.

Manach · 03-11-2014 10:23pm

What a group can except is in direct proportion to its bargining power. Analagous to to oversea Corporations and the corporate tax rate, consultants are integral to the Health sector and can fairly move elsewhere to operate.
This is how this has been initially set-up and maintained and seems to be mirroring the NHS but without the deep pockets of the UK exchequer.
Thus the Drs. knowing their inherently strong position are acting rationally to maximise their worth.

FreudianSlippers · 05-11-2014 10:07am

nice_guy80 wrote: »

why not?
the cost of hiring legal help in Ireland is extortionate.

Compared to the UK and the US it isn't. Legal services are also private for the most part; not state controlled. You're advocating a nanny state where all jobs have set rates?

nice_guy80 · 06-11-2014 8:42pm

FreudianSlippers wrote: »

Compared to the UK and the US it isn't. Legal services are also private for the most part; not state controlled. You're advocating a nanny state where all jobs have set rates?

I'm saying doctors and the law profession should have to publish their fees publicly and let the consumer decide where the best service is.

Plus, there should not be such tight restrictions about GPs and law firms here. The state should be setting the competencies for doctors and lawyers, not the likes of the IMO, Law Society and the Bar.

FreudianSlippers · 07-11-2014 11:00am

nice_guy80 wrote: »

I'm saying doctors and the law profession should have to publish their fees publicly and let the consumer decide where the best service is.

Why? Where does it end? Plumbers and gardeners should have to publicly publish their fees too then!

Plus, there should not be such tight restrictions about GPs and law firms here. The state should be setting the competencies for doctors and lawyers, not the likes of the IMO, Law Society and the Bar.

I'm not sure what you mean by that? You think it should be just any Joe off the street can call himself a doctor or lawyer and that's that?

Godge · 07-11-2014 11:05am

Sand wrote: »

The key thing is Ireland pays what it can afford. As a country living hand to mouth, reliant on the kindness of strangers and trying to shove spending off balance sheet wherever possible (i.e. Irish water) that is not much at all.

Talking about what people can make in other countries is nice, but not relevant. Ireland is paying what it can afford. Other countries can pay more, and they will *maybe* get more (the Irish record is pay more with no actual benefit detected). If Irish consultants really are all that, then by all means they should go abroad, compete for those roles and successfully get them. I wish them the best of luck.

Meanwhile, Ireland should only pay what it can afford.

The Irish public sector has a long habit of benchmarking its pay and benefits to best in the world levels. It is long overdue that the only important benchmark is applied: what Ireland can afford.

If we continue on the merry road of paying "what we can afford" which is your view, we will end up with a serious number of vacant consultant posts and half the rest filled on an agency basis.

Oh, we are already there.

Dannyboy83 · 07-11-2014 8:59pm

The Corinthian wrote: »

I agree and also not. Tax, cost of living, salary levels, infrastructure all add up to quality of life, so it's not all about salary. But when you have a country like Ireland where cost of living is relatively high, as is tax (when you consider indirect taxes), public transport is a joke, child care expensive, and so on, then increased salary is how you compensate people and get them to work in a 'hardship post'.

Pretty much spot on

Reasons for emigration:
Working hours
Work–life balance
Income levels
Career pathway

The main issue identified is working hours.
Increasing pay will not fix the issue, due to excessive taxation.

Reform working hours and taxation, doctors will probably work for less

Royal College of Surgeons in Ireland Student Medical Journal 2013
http://www.rcsismj.com/wp-content/uploads/2013/ChalikondaL-Emigration.pdf

Table 1: A comparison of income levels between Ireland, the UK and Australia.

Income per annum Working week Tax (single)
Ireland €38,839-€54,746 48 hours
20% on first €32,800
41% on the remaining balance

United Kingdom £22,412-£29,705 40 hours
20% on first £34,370 (€40,360)
(€26,494-€35,116)
40% from £34,751-£150,000 (€41,081-€177,324).
50% on income over £150,000 (€177,324)

Australia Aus $60,000-Aus$75,000
38 hours
The first 30% of income is tax free. (€46,313-€57,891)

Remaining 70% is taxed at $3,572 + 32.5% for income levels between $37,001 and $80,000

The Postgraduate Medical Education and Training Group (MET) in
Ireland published a report in 2005, which addressed the state of
postgraduate medical training in Ireland as well as the issue of
medical emigration.34 The report was compiled with the former
Minister for Health, Mary Harney, members of the MET and
government departments.
The chairperson of the MET, Jane
Buttimer, stated that the reduction of working hours, reformation of
medical education and the improvement of medical care are among
the strategies laid down in order to improve the Irish health system.

Also contained in the report are factors that have influenced doctors
to emigrate, which are not unlike the ones discussed above. These
include, but are not limited to, shorter working hours, acceptable
workload, better working conditions, better pay, and location of
medical posts. These are the results of a survey on two cohorts of
medical graduates from 1994-1999. This report shows that these
issues are known and efforts are being made to address them. The
report gives a detailed description of the plan of action for the
Minister for Health and the HSE on improving the overall quality of
the Irish health system. Accommodating NCHD training within the
Page 96 | Volume 6: Number 1. 2013
staff review RCSIsmj48-hour working week, safeguarding training and service delivery,
implementing the National Flexible Training Strategy to retain
graduates, establishing a strong Medical Education and Training
Programme by the HSE (HSE-MET), and creating a funding base
for postgraduate education and research are among the numerous
strategies detailed in the report. In relation to the health of
doctors, the HSE is also considering integrating modules on
dealing with illness, stress and understanding the systems available
to doctors who are ill, into undergraduate and postgraduate
training. Further measures include the following: ensuring that
occupational health services are made available to doctors,
including those in rural areas; providing assessment and retraining
after long illness or absence from work; and, creating a mentoring
network to meet the retraining needs among doctors.34 Increasing
the number of postgraduate training posts is another factor that
needs to be considered, as it is contributing to the emigration of
doctors.34
The IMO is aware of the problems regarding NCHDs and hospital
care, and has implemented a plan of action for retaining NCHDs: a
training fund; two-year NCHD contracts; EWTD implementation;
public holiday leave; professional competence; overtime payments;
career plans; improved working conditions; education and
training; a 39-hour core working week; and, GP travel allowance.

The working hours issue is quite particular to Medicine

The excessive taxation is not of course:

OUR "best and brightest" are paying too much tax and should be given some relief to stop the brain drain, a senior minister has warned.

62pc of recent emigrants have a degree from a third-level course of three years or more.

He also pointed out that not only has the economic crisis reduced salaries, but workers were being moved into the higher rate of tax – at 52pc – when they are earning average wages.

Tax relief for foreign executives extended in Finance Bill

flutered · 07-11-2014 9:06pm

how many times did the troika demand that the health and law sectors be straightned out, theres two were higher up the agenda than water tax.

FreudianSlippers · 08-11-2014 11:48am

flutered wrote: »

how many times did the troika demand that the health and law sectors be straightned out, theres two were higher up the agenda than water tax.

Doctors in Ireland are criminally underpaid. The Legal Services Regulation Bill has been sitting the Oireachtas for 3 years now. Promised to be passed before end of the year, but the water nonsense has slowed it down. I think that people will find when they send their fees to taxation that 8 out of 10 fees are entirely reasonable for the work done.

nice_guy80 · 08-11-2014 12:11pm

FreudianSlippers wrote: »

Doctors in Ireland are criminally underpaid. The Legal Services Regulation Bill has been sitting the Oireachtas for 3 years now. Promised to be passed before end of the year, but the water nonsense has slowed it down. I think that people will find when they send their fees to taxation that 8 out of 10 fees are entirely reasonable for the work done.

Figures. Prove that doctors are underpaid

http://www.independent.ie/irish-news/health/top-earning-gp-grossed-nearly-800k-in-a-year-30063377.html

I think average earnings are around €120,000 for a private practice

Berserker · 08-11-2014 12:13pm

nice_guy80 wrote: »

between the doctors and lawyers it is no wonder the country is still borrowing €5 billion a year

Dear or dear. Yes, the doctors are lawyers are the problem in this country ..... :rolleyes:

FreudianSlippers wrote: »

Doctors in Ireland are criminally underpaid.

nice_guy80 wrote: »

how could a salary from €125,000 - €175,000 not be considered a good salary?

My OH is a doctor. She studied and trained here and is qualified for a few years. We will be moving to Canada, her home, in a year or two, as the salary, overall package and working conditions are far superior to those here. This is standard for people who come to Ireland to train as a doctor. The training costs are very cheap here but the pay and working conditions are poor in comparison to abroad. Agencies come here to try and get (pay) doctors to come to Canada, as there is a shortage of doctors there (GPs in particular).

Gongoozler · 08-11-2014 12:20pm

Just as a slight aside there, doctors don't generally have to pay for lawyers, it's a requirement that they have insurance when working privately and if working for the state they're covered by CIS. If you're getting to the point of going to court, then maybe it's different, maybe they do have to pay at that point I'm not sure.

Carry on.

FreudianSlippers · 08-11-2014 12:28pm

nice_guy80 wrote: »

Figures. Prove that doctors are underpaid

http://www.independent.ie/irish-news/health/top-earning-gp-grossed-nearly-800k-in-a-year-30063377.html

I think average earnings are around €120,000 for a private practice

Dr Nic · 11-11-2014 11:00pm

Sand wrote: »

1 - Talking about what people can make in other countries is nice, but not relevant.

2 - Ireland is paying what it can afford.

3 - The Irish public sector has a long habit of benchmarking its pay and benefits to best in the world levels. It is long overdue that the only important benchmark is applied: what Ireland can afford.

1 - How is it not relevant? In case you havent noticed there are 10s if not over 100 consultant posts unfilled in this country. So we are directly competing with other countries to recruit consultants. Direct competition for a job. I would say salary is very relevant.

2 - You said that plenty of times. Doesnt make it true

3 - Would you be happy with a consultant operating on your child or loved one who cant perform the surgery safely? It does happen and people die.

Medicine is a mobile market and there is a worldwide shortage of well trained doctors. Our best are leaving and will always leave while this 2 tier BS continues. I am already planning my departure.

We are just about lucky in that we have enough of the world class consultants on the old contracts to hold things together. But soon enough those lads will retire or leave the country due to overwork/disillusionment.

And then we'll have to resort to promoting the lads who are not up to scratch but get the job because there is no-one else. People are already dying unnecessarily from the third world overcrowded conditions in our hospitals. But then it'll be like the walking dead...

Dr Nic · 11-11-2014 11:02pm

Gongoozler wrote: »

Just as a slight aside there, doctors don't generally have to pay for lawyers, it's a requirement that they have insurance when working privately and if working for the state they're covered by CIS. If you're getting to the point of going to court, then maybe it's different, maybe they do have to pay at that point I'm not sure.

Carry on.

What do you mean? A surgeon colleague of mine told me he has to work til June each year to pay his insurance alone...

And each year it creeps later in the year due to some BS mistake made by his reg

Dr Nic · 11-11-2014 11:05pm

nice_guy80 wrote: »

Figures. Prove that doctors are underpaid

http://www.independent.ie/irish-news/health/top-earning-gp-grossed-nearly-800k-in-a-year-30063377.html

I think average earnings are around €120,000 for a private practice

You do know your figure there of 800k is gross?
120k is about 6months work or less in Canada. With way less bullsh1t to deal with. And no begrudgers to listen to either

Gongoozler · 11-11-2014 11:09pm

Dr Nic wrote: »

What do you mean? A surgeon colleague of mine told me he has to work til June each year to pay his insurance alone...

And each year it creeps later in the year due to some BS mistake made by his reg

Did you read my post?? I said that if in private practise they must have indemnity cover. I wasn't disputing paying insurance. I was stating that they have to have it. What did you miss there?

Dr Nic · 11-11-2014 11:16pm

I missed and still miss the point of your post with 'generally' and 'im not sure' thrown in there. Did you make all of that up?

Gongoozler · 11-11-2014 11:25pm

Dr Nic wrote: »

I missed and still miss the point of your post with 'generally' and 'im not sure' thrown in there. Did you make all of that up?

Jesus what's got your back up?

No I didn't make anything up. If you're a doctor you should be aware of the requirements for a doctor to have insurance.

Memnoch · 11-11-2014 11:34pm

The problem isn't salaries per say, it's the crippling taxes and USC. Salaries aren't that much higher in the UK but allow a much higher standard of living compared to ireland.

Dr Nic · 11-11-2014 11:43pm

Gongoozler wrote: »

Jesus what's got your back up?

Your double question mark and tone.
Anyway...

Dr Nic · 11-11-2014 11:47pm

Memnoch wrote: »

The problem isn't salaries per say, it's the crippling taxes and USC. Salaries aren't that much higher in the UK but allow a much higher standard of living compared to ireland.

I dont think its even the money from any pov either tax or salary. Its the bull**** managers and pencil pushers who make your life hell.

Doctors cannot make decisions anymore in this country.

And the frequency of on call...
There is no ewtd for consultants.

conorh91 · 12-11-2014 12:59am

Dr Nic wrote: »

Doctors cannot make decisions anymore in this country.

The biggest complaint I hear from NCHDs whom I know is that their consultants are essentially their managers; they are opposed to EWTD and (emotive language notwithstanding) they are considered slave drivers

There is no ewtd for consultants.

That's because they exercise autonomy in their role, similar to any sufficiently senior manager, or self-employed person in any area of the economy.

Sand · 14-11-2014 11:35pm

Dr Nic wrote: »

1 - How is it not relevant? In case you havent noticed there are 10s if not over 100 consultant posts unfilled in this country. So we are directly competing with other countries to recruit consultants. Direct competition for a job. I would say salary is very relevant.

Not really - sure another poster in support of the IMO was telling me it wasnt all about salaries, now another poster in support of the IMO is telling me its all about the salary. The reality is that salary is relative to what the employer can afford to pay for the asset (the employee), and what the employee can make for their asset (their time and expertise).

If Irish consultants could make the rock star salaries, they'd be abroad making them. We are dealing with the dregs. The whingers and the moaners who cant be bothered going abroad and competing. They want to stay at home and *still* get the rock star salaries but without having to bother competing with the actual best in the world.

I support the best Irish consultants going abroad and competing for world class salaries if they think they are up for it. But the boys and girls who aren't will have to benchmark themselves to Irish salaries, rather than world class salaries.

2 - You said that plenty of times. Doesnt make it true

I'll say it as often as it takes to sink in.

3 - Would you be happy with a consultant operating on your child or loved one who cant perform the surgery safely? It does happen and people die.

These would be the world class Irish consultants you want to benchmark to world class salaries? Those are the people who cant perform surgery safely?

Paying that class of consultant more wont lead to better results. It will lead to bad and average consultants getting more than they are owed due to no competition at all.

Medicine is a mobile market and there is a worldwide shortage of well trained doctors. Our best are leaving and will always leave while this 2 tier BS continues. I am already planning my departure.

Okay, good luck. Irish astronauts have to emigrate to grow to their true potential. You will too if you cant get by on a measly 175,000 Euro a year.

We are just about lucky in that we have enough of the world class consultants on the old contracts to hold things together. But soon enough those lads will retire or leave the country due to overwork/disillusionment.

And then we'll have to resort to promoting the lads who are not up to scratch but get the job because there is no-one else. People are already dying unnecessarily from the third world overcrowded conditions in our hospitals. But then it'll be like the walking dead...

Finally! Finally we get down to brass tacks.

You're right - conditions and work practises in the health service are ridiculous. I don't see how that is solved by trying to pay the consultants rock star wages.

Actual reform is required - but that might mean consultants needing to accept less than rock star status. Do you really think the current situation in Irish hospitals was arrived at by accident?

Are the IMO deluded?

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