HSE proposed pay cuts for junior doctors from February 18th...

forgetting about any other sector of the employed, the one group of people that I'd want totally trained up are feckin doctors! This is pretty much madness. I don't think anyone realises just how badly this is going to hit things on the ground if its carried through on.

I'd talk to a lot of doctors day in and day out and the sense of impending despait among the lads and lasses is terrible. You know whats going to happen? They're all going to f**k off to somewhere we're they are actually appreciated and get a decent level of training etc.

Has anyone got a link to all this?

So if I'm working one in 6, I'm only gonna be working 4 days a week? What if a Reg and SHO are on call together - is the intern gonna run the show on his/her own for 2 days?

I'd love to know what percentage of the HSE's salary cuts are being taken up by NCHD's (who make up 5% of the HSE staff).

What are they going to say to all the mature students who they encouraged into 4 year spots? How are they gonna get their 48k investment in their future back?

How are doctors supposed to pay for expensive courses? Will teachers not be paid for in-service days now? Will nurses be forced to take annual leave for various courses? Like **** they will. (No disrepect to either group by the way) Watch the standard of healthcare in Ireland fall as less well trained medics climb the ladder a lot slower.

My plan was to go to Australia in July and come back for the BST interviews the following February. I may not bother coming back now.

This is because they see NCHDs as the weakest link- they feel that you are so worried about your careers that you wont withdraw your labour.

less and less LC students are going to consider Medicine as a career if they have any sense. I know for certain I will be steering my children away from it.[/quote]

yeah your right medicines points are going to crash through the floor :rolleyes:

galway_girl wrote: »

REDELEPHANT - what a stupid and irresponsible comment to make on a public forum that anyone with access to a computer can read. Be assured that your comment will be used against us a group as we are in the run-up to industrial action. I, like the majority of NCHDs, did not abuse my grant and found it extremely difficult to even get it paid to me - I am still owed money which I am sure now I will not receive. However, it is the minority of cases like yourself that are used as examples by the media as part of anti-doctor propaganda. You're a disgrace and an embarassment to the profession and it will not be to defend people like yourself that we will pursue industrial action, it is to defend entitlements that ensure a high standard of post-grduate training in this country. Two further points - one, you are not required to use your training grant just because it is available and two, to falsely claim for courses/laptops/PDAs etc on the training grant is fraud.

one would wonder about the truth behind this comment to be honest. Unless someone was already coming from a pretty monied background, i find it hard to compute how the grant could pay for all of that along with say RCSI fee's etc

unless you are an intern, every SHO and Reg has RCPI or RCSI exam fees to pay or memebership charges.

The training grant is well used and appropriately in almost every way.

ergo wrote: »

The IMO has been informed by the HSE that the following cutbacks will be enforced from February 18th: (cutbacks for NCHD's)

Training grant will be cancelled

Living out allowance cancelled

Higher degree allowance cancelled

Diploma allowance cancelled

Mandatory pre-call day off without any pay

Mandatory post-call day off without any pay

Mandatory one-hour unpaid lunchbreak each day

Interns to be restricted to 48hrs paid hours only from July 1st

Cutting in CORE BASIC pay (unspecified percentage)

Overtime to be cut from time-and-a-quarter for the first 15 hours to TIME ONLY

OT 1st 9 hours at Flat time 100% (not really OT at all)
Balance of hours at 125%


All this is on top of the income levy and the newly-announced pensions levy.....................

This is only part of the memo sent to the IMO. the rest is as follows:

Rosters formulated 8am to 8pm
Hospitals to examine and eliminate unnecessary layers of on-call
Maximisation of on call off site where feasible
Cross cover across different specialities to be maximised
Full roll out of successfully concluded NIG pilots
Interns employed on 48 hour week from 1 July 2009

Ok, NCHDs are being attacked on 3 fronts - finances, training and working conditions.

1. Finances - The lesser of the 3 evils. The rest of the public sector (rightly or wrongly) are quite upset about the pension levy. If that was all NCHDs had to worry about I'd be popping open the champagne about now. Our pay is going to be savaged. The HSE, by doing this, obviously value the hospital cleaners more than the doctors.
What also gets my goat is, despite RTE getting to see the above document, thier reports continue to harp on about 'unpaid luchbreaks' - as if that was the most pressing issue!!!!

2. Training - No training grant + not being paid for hours spent at in house training + much less senior supervision + horrendous working conditions = the worst quality medical training in the western world. Training courses (ACLS,ATLS,PCLS) are ridiculously expensive as are exam and college fees. This on top of a massively reduced take-home pay.

3. Working Conditions - Personally, this is the worst consequence of what the HSE is proposing. We already work in appaling conditions which are just about bearable. We will now be chronically understaffed if the HSE's proposals are implemented. Pre and post-call day off (unpaid)!!!!! Take a service with 4 SHOs (I will be working in such a post this July). 1 person on call, 1 person post-call is at home, 1 person pre-call is at home the other 1 is on site. 2 SHOs working at any one time when there was once 4.
"Eliminate unnecessary layers of on-call" - this means what exactly? For example does it mean where once a Paeds SHO and Reg were on call, now its just the SHO?
"Maximisation of on call off site where feasible" - This is already happening to Psychiatry SHOs in Galway, where they are being paid off-site rates despite repeatedly telling management that the volume of work requires them to be on-site virtually all of the time.
All this means is that if someone attends an Irish hospital out of hours, or is an inpatient that requires medical/surgical review out of hours, they will either be seen by a junior with no senior back-up or will have to wait for the doctor to come from home or not be seen at all.
This coupled with poor standards of training impact even further on aptient care.
Its a highly stessful and untenable sitaution for Irish doctors with potentially fatal consequences for Irish citizens.

It really isn't an issue of being out of pocket for me, it is the proportion compared to other HSE workers, to the rest of the public service. We may not get much sympathy from those who have lost their jobs (understandably) but those same people had better hope they or their loved ones do not require hospitalisation after these changes are brought in. It is the erosoion of services and the awful conditions we will be expected to shoulder - understaffing, huge workloads and reduced access to senior supervision- that is really galling.

I'm the kind of person who likes to devise personal contingency plans in crises such as these (of course the plans dont always work out, but making them helps me control the rage I am currently feeling.)

This is how I will be proceeding:

If the cuts and dangerous changes to work practices are implemented I will support any ballot for industrial action.
The HSE may or may not decide to engage with the IMO.
Depending on this industrial action may ensue.
It may work, it may not.
If it doesn't I will resign from my training scheme and seek employment abroad. I never planned to emigrate, I don't like the idea of living far from my family, but if it comes to it I will.

I will also support industrial action - but we need to be careful. Doctors are regularily assaulted by the media and the spin will only be beginning.

In truth, there are only a small number of HSE staff who are regularily paid overtime. Lab Scientists, Physiotherapists, Radiographers and Doctors. The former 3 have a large retinue of specialised staff working across specialised disciplines and then condense into a small emergency service only on call and thus their on call rota is better (in major hospitals anyway). Doctors are nearly expected to provide a full diagnostic service on call as off call (bar most elective surgery - chemo is given as normal as is cardiology management as examples) This means due to tight service requirements, we have a tight on call rota and would regularily clock 80-100 hours per week (some dipping to a minimum of 60 and others hitting 120).

Most public servants do no overtime, but receive TOIL (Time off In Lieu) for hours worked - ie you do 6 hours overtime, you get a half day off instead. This applies to most staff in the allied health disciplines.

So the burden to cut "unneccesary" overtime falls the hardest on doctors. This is very reasonable to someone who has no idea of the work we do which includes most members of the HSE.

There is a gross misunderstanding of our work environment within the managerial structures of the HSE, instead they just see overtime sheets going in and payslips going out. Their only true interaction with us would be in A&E where they get a bad service like everyone else (due to understaffing) as most would opt for private insurance and private consultations. There is animosity within the senior ranks as although the managerial element controls the purse-strings of the hospital, they have no actual say in the dispensation of the majority of the funds as this is controlled by the clinical directors who are consultants and have a higher salary than CEO's.

I was chatting to a non-clinical staff member from my old medical school (i popped in to get some documentation sorted) and she commented on a case of a students who left her intern year half way through because she could not cope with on call. The comment on the doctor was "she should have known what she got herself into" "everyone else manages on call". This is the pervasive attitude in the HSE - that when we are on call, we spend most of our night in bed and review the occasional patient - the truth is anything but. When i did medical call last year for the entire year - I slept 30-60 minutes per shift. I was on a 1 in 9 rota. My reg would relieve me for that time - I always arranged that myself so that the senior was more alert on the post call round.

With the increase in service requirements due to more specialised treatments, on call is busier and busier, admission rates are higher and case complexity much greater. People are living longer due to a cocktail of drugs and complicated surgery. No longer are people coming in with pneumonia, they arrive with that, heart failure, kidney failure and the antibiotics you start them on interact with all their other tablets and throw everything out of whack. Finally they get MRSA or C. Diff and stay for another 2 weeks in hospital. Then there is no convalesence, nursing homes or any other form of home care package to support the relatives who truly love the patient and want them home, but totally cannot cope.

Here we actually need an increase in service provision so that TRAINING can occur and junior and middle ranking staff become better at their jobs at look after people much better.

The opposite will be the case.

I always had a bad feeling that things were going to go hell in Irish Medicine right from July - but this is spectacular.

I am emigrating and departing in May - off to Oz where the weather is warmer and i have time to care for people rather than firefight the chaos back.

Join me.