Irish Times: HSE wants to halve overtime in €350m savings plan

Amnesiac_ie

HSE wants to halve overtime in €350m savings plan

MARTIN WALL, Industry Correspondent



THE HEALTH Service Executive has told trade unions that it wants to reduce overtime across all grades by 50 per cent next year as part of work practice reforms aimed at saving about €350 million.

HSE management has also said that it wants to save more than €50 million by ending special grants, payments and allowances made to non-consultant hospital doctors.

It has also proposed introducing new centralised arrangements for contract procurement, which it maintained could secure about €25 million in savings.

HSE management and health sector trade unions are currently engaged in intensive talks on work practice reforms, which management has maintained are vital to allow it to live within its financial allocation from the Government next year.

The HSE has received a much lower level of increase in exchequer funding for 2009 than has been the case in recent years. It has also been told to find the funding for a 3.5 per cent increase due to its 110,000 staff next September from its own resources.

This is expected to cost it more than €100 million.

Earlier this month The Irish Times revealed that the HSE had proposed a new cost-containment plan which included introducing new restrictions on recruitment, reviewing contracts of temporary staff and reforming annual leave, sick leave and expenses arrangements.

However, the confidential document did not spell out precise costings for the measures proposed.

In a presentation to unions last week the HSE said that it wanted to generate about €350 million in savings from work practice reforms and efficiency measures.

It proposed ending paid meal breaks for non-consultant hospital doctors and estimated that this could generate €25 million.

The HSE said that ending the payment of a living-out allowance for non-consultant hospital doctors could realise €12 million while the suspension of a €4,000 training grant could produce €16 million.

The HSE also argued that in some hospitals there were various "layers of on-call cover". It said that this involved a number of grades of non-consultant hospital doctors being on call in different specialities at any one time. It suggested it could save €100,000 per year by removing each "layer" in each hospital.

The HSE has also forecast that the introduction of a centralised procurement system could save €25 million. However, this could have implications for administrative staff, represented by Impact, who currently arrange procurement contracts on a local basis.

The HSE maintained that a reduction in overtime by 50 per cent could generate savings of about €110 million.

It suggested that this money could be realised partly by restricting some wards to five-day operations and making savings on the use of agency staff currently recruited to provide services on a seven-day basis.

The HSE also proposed a number of one-off measures such as suspending payment for academic courses for staff. It argued that this could save nearly €5 million next year.

It is understood that unions at the meetings last week argued against the proposed changes put forward by the HSE.

Unions are also understood to have put forward a number of principles which they wanted acknowledged by management. These included the protection of services as well as the maintenance of employment and terms and conditions.

Unions have also argued that they could not accept proposed changes in areas such as travel and subsistence and sick leave for health service staff as these are governed by agreements spanning the entire public service.

HSE management is expected to respond to union concerns at meetings later this week.

Amnesiac_ie

Amnesiac_ie wrote: »

HSE management has also said that it wants to save more than €50 million by ending special grants, payments and allowances made to non-consultant hospital doctors.

Training expenses as a medical SHO

• RCPI GPT Fee €2000
• MRCPI Parts 1, 2, 3 €1800
• Revision books and courses for MRCPI €500-€2000
• MRCPI membership fee €500

These are the bare essentials of training as an SHO in internal medicine; it does not include any other courses such as ACLS, subspecialty courses, journal subscriptions. The current training grant of €1,960 every six months is a mere contribution to the costs of basic training. Scrapping it will leave Irish doctors footing their entire training bill themselves.

It proposed ending paid meal breaks for non-consultant hospital doctors and estimated that this could generate €25 million.

Newsflash to the HSE: junior doctors do not get a paid meal break. Are you suggesting junior doctors should be entitled to a one hour lunch break every day? Well that sounds nice! How about we all hand in our bleeps and arrest bleeps for a designated hour every day and walk into town for a nice lunch. Who is going to cover the wards and the emergencies whilst we are enjoying our new unpaid lunchbreak?

The HSE said that ending the payment of a living-out allowance for non-consultant hospital doctors could realise €12 million while the suspension of a €4,000 training grant could produce €16 million.

Oh so the living out allowance will go too. Well maybe Dublin and Cork based NCHDs should stop going to peripheral hospitals for rotations then.

The HSE also argued that in some hospitals there were various "layers of on-call cover". It said that this involved a number of grades of non-consultant hospital doctors being on call in different specialities at any one time. It suggested it could save €100,000 per year by removing each "layer" in each hospital.

Hilarious. "On-call cover" in Irish hospitals is provided by tired doctors working illegal 32hour+ shifts. It is dangerous and skeletal at best. The HSe thinks it can be reduced further? Well boys, the standard of cover as those of us who are on the inside well know is dangerous and incompetent as it stands... if there are to be less doctors on call... well it's one way of freeing up a lot of acute beds and the funeral homes will weather the economic crisis nicely...

The HSE also proposed a number of one-off measures such as suspending payment for academic courses for staff. It argued that this could save nearly €5 million next year.

Doctors are not paid for academic courses. We used to use our training grant. I guess this refers to other health professionals. Sure let's all stop training together; that way we can all feel equal as we deskill.

It is understood that unions at the meetings last week argued against the proposed changes put forward by the HSE.

I should bloody well hope so.

HSE management is expected to respond to union concerns at meetings later this week.

And I want the IMO to inform me and every other paying member immediately of what is being discussed

RobFowl

This is incedibly short sighted. The whole point of NCHD posts are that they are training grades. The quality of the training is poor enough at times anyway. Cutting back will lead to more doc's going abroad for their post grad training and make it harder to recruit quality candidates.
Bare in mind the DOH/HSE have just given consultant salaries a huge hike and by co-location they are going to reduce the substantial income public hospitals get from treating private patients.
Time for the IMO to earn its membership fee's methinks

Amnesiac_ie

I'm strongly urging every NCHD I know to get in touch with the IMO and highlight that the above suggestions are completely unacceptable. The HSE obviously sees NCHDs as a soft touch, and is banking that in these times of economic gloom it will be possible to unilaterally impose drastic income cuts on NCHDs whilst appealing to the public for "support" in the national interest.

A wage freeze I can live with. Paying more tax as a higher earner in times of economic downturn I can live with. We need a new NCHD contract and reduced hours and I accept reduced wages will definitely be necessary. But unilaterally deciding to change the current contract, realistically expecting mugs to come in and work without pay and fund their own training is completely out of order.

If all the ideas in that article were implemented a lot of NCHDs would see their income cut by 25%.

We need to stand up to the HSE. We can debate and negotiate a new contract in a fair and open way. Threaten us with the above nonsense can only result in industrial action and that is something the already chaotic health service cannot afford.

RobFowl

Amnesiac_ie wrote: »

It proposed ending paid meal breaks for non-consultant hospital doctors and estimated that this could generate €25 million.

Paid lunch breaks
What planet are these people living on. Grabbing a sandwich between calls while carrying at least one pager is hardly a luxury.
Mrs Fowl is a nurse and she has protected but unpaid lunchbreaks, While working in the same hospital I was regularly covering wards, OPD and treadmill's during "lunch breaks".
Do they want to stop admitting and treating patients between 1 and 2 every day ??

Amnesiac_ie

RobFowl wrote: »

Paid lunch breaks
What plalnet are these people living on. Grabbing a sandwich between calls while carrying at least pager is hardly a luxury.
Mrs Fowl is a nurse and she has protected but unpaid lunchbreaks.
Do they want to stop admitting and treating patients between 1 and 2 every day ??

Bring it on! The staff in switch can hold my pager and my arrest bleep whilst I nip to Clontarf for some Beschoff's.

sam34

doesnt it highlight how incredibly out of touch the powers that be are, that they actually think we get paid lunch breaks.LOL!

Vorsprung

The spin is incredible. The headline says they're going to have overtime - bull****! They're just gonna stop paying it. If they get away with it, we'll start heading towards the American situation - overtime isn't paid and we all turn up at 9am. But then one guy comes in with the boss at 7am, and he gets the upper hand in terms of references for schemes. The the rest have to come in at 7am so we don't lose out. We lose. HSE wins.

Traumadoc

They are really in a lot of trouble, they are trying to get the single rooms free so they can start charging private patients again.
We wont get the agreed awards with the new consultant contract- they cannot afford it - although its the NCHDs who will suffer more.
If the education expenses go I can see industrial action, they should be at least tax deductable.
I can see the closure program escalating and some of the smaller hospitals will go this year.

Co-location I feel is dead.

The mealbreak thing was done in St James a number of years ago, all the NCHDs handed in their bleeps at lunchtime.

jon1981

as an ordinary member of the public it really annoys me how so far all their cost cutting measures proposed thus far are around the medical staff, why haven't they released the proposals about the bloated admin and managerial areas!

Bison

It’s been well pointed out above why these cuts are ridiculous so I won’t dwell on them but how about a few cuts from the Office and Admin section of the HSE 2007 report? Now some of these expenses could be well justified but since this is all the detail the tax payer gets from an agency that spends 14 billion I might as well ask the questions....

Legal and Professional Fees 55 million
How about the legal teams take a pay cut? Plenty of solicitors looking for work these days....

Agency Services 18 million
For what? PR perhaps.... to tell the public how great everything would be if it wasn’t for those doctors...

Bad & Doubtful Debts 14 million
Up 3 million from 2006.

Education & Training 26 million
Would it not be better to train the front line staff?

Travel & Subsistence 93 million
What the hell? Barack Obama’s presidential campaign probably didn’t spend that travelling around the US. Try video-conferencing!!!

Office Expenses/Rent & Rates 167 million
Whats the split on stationery, ESB, biscuits for coffee breaks???

Computers and Systems Maintenance 44 million
Are we giving everyone a new computer every year?

Sundry Expenses 17 million
Maybe a few savings here?

Vorsprung

jon1981 wrote: »

as an ordinary member of the public it really annoys me how so far all their cost cutting measures proposed thus far are around the medical staff, why haven't they released the proposals about the bloated admin and managerial areas!

Managers / admin = members of Siptu/Impact etc. Basically big unions. So if they're pay gets cut in the morning, you'll be walking to work, your bins will lie uncollected and your flights will be delayed because the baggage handlers will all be on strike in defence of their fellow union members.

IMO = smaller union, without the same clout. Plus doctors are easy prey.

ergo

sam34 wrote: »

doesnt it highlight how incredibly out of touch the powers that be are, that they actually think we get paid lunch breaks.LOL!

tbh I thought lunch breaks were paid

ie. basic working week is 900-1700 Mon-Thurs and 900-1600 Friday = 39 hours so all time spent in the hospital is paid for, even when sitting in the canteen

in Australia I had an 8 hour day which was 800-1630 with 30 minutes (unpaid) for lunch

dr69ddk9

The IMO is a truly weak organisation. It needs to grow some balls and we need to help them do it. The debacle on Thursday night at the Odeon is a testament to that fact. Our spokesman is a Psych Reg - failed comedian. We could do without a funny man as the face of our NCHDs.
Its like having Harney as the poster girl for the Ministry Of Health. How are we expected to be taken seriously if Krusty the Clown is fighting our corner.

Unpaid lunch. Gimme a break. I aint taken an hour for lunch since I was in College. Being a surgeon i make do with a quick cup of tea and some toast when i get the chance. And the medics..... What does Professor Drumm expect them to do with their bleeps during their lunch hour. Perhaps Joan and Mary at switch could do the ACLS and cover all arrests during this hour of sanctity.

loss of grant = loss of training. we need to let Joe Public know that we will become inferior doctors secondary to inferior training if the grant goes


Dont get me started on the HSE middle managers. Coming from a home where a member of my family worked (high up) for the Health Service and was present during the centralistion debacle, i am well informed how the HSE made the first calamity (of many). It all started by their poor insight into how the supposed redundancies of the surplus middle managers should take place. They neglected to forsee the strength of the trade unions and how these unions fought tooth and nail to keep people in jobs who are surplus to requirement. Strong redundancy packages were offered but unions objected. and now, there are numerous positions throughout the country occupied by "the clip board holders" and the like still. These jobs should have been vacated but the HSE were blind in their foresight. Their are now jobs in EVERY single hospital in the country not required and in some instances three or four people are doing the work of one person due to the HSEs failings. If the IMO were an astute organisation as the others, we would not be facing these proposed ludicrous cuts.

The IMO is akin to the Peoples Front of Judea in "The Life Of Brian" . All talk and even less action. Poorly run and poorly supported.

However, it is our only tool in fighting the HSE and the Government in their proposed actions.

we will have to meet them (HSE etc) in the middle at some time. An agreement will need to be reached. But we all need to step up to the mark and fight our corner. The harder we fight this, the better the middle ground will be.

and finally (excuse me for this rampant tirade), I think industrial action would be an extremely stupid manouevre. Firstly, think back to the nurses "work to rule" carry on a couple of years ago. They lost the public support and they made themselves out to look like idiots over their wanton 37.whatever number of hours.

Secondly, I dont adhere to the Hippocratic oath inherently yet i think doctors taking industrial action is immoral and it will only outrage the public, who already probably think we are overpaid and overpriveleged.

in conclusion, i urge you all to join the IMO. This will give the organisation some creedance and strength for the first time and will give us all a better chance of fighting and winning this latest battle that the HSE have thrown our way.

Remember, Prof Drumm is earning 450K plus per annum for an admin role. Essentially he is a "clip board holder" at the top. Earning three times more now than he ever did when he was Professor of Paediatrics at crumlin.

We must fight the fight. If not, pick up your clip board and become a middle manager. Your Trade Union will definitely sort you out if join them.

Lets hope our union grows some testicles and fights our corner. For a change....

Join the IMO,

I'm just about to do it!

Viva La Revolution!!

Traumadoc

You would have lots of support if you campaigned for a pay cut for Brendan Drumm.

RobFowl

Traumadoc wrote: »

You would have lots of support if you campaigned for a pay cut for Brendan Drumm.

just a quote from Prof Drumm here Traumadoc. To me it shows just how out of touch he is. Cut the frontline services, close beds, stop proper training and yet !!!!!!!

"However, pressed on whether the HSE itself could not decide to defer the bonuses for its own senior staff, he said it would be unfair if he went to the people who work for the HSE, and said to them just because they worked there they would be asked to forego their bonuses, but if they worked elsewhere in the public service they would not be asked to do this.

“You can imagine what that does both for this organisation for recruitment and for retention of staff. I don’t think it is something that the HSE can be expected to do and still retain its best people.”

On his own remuneration and the often negative comments about it he says: “I think this is incredible considering that most people in the health service in clinical posts at my level, in fact a very significant amount of them, earn far more than me, between their public and private practice.”":eek:

PoleStar

Going on strike?

This wouldnt be necessary, not even a dogmatic work to rule would be necessary.

If the HSE cuts unrostered overtime and brings in un paid lunches, all we would have to do is do what the HSE wants!

God I cant wait, I can have a lie in every day now! I will be able to head off down to the local coffee shop of pub for a NICE lunch!

Lets see how long that lasts. Lets see how short theatre lists would get to give time for morning rounds before theatre and maybe finish theatre by 4 so evening rounds can be done. Lets see how many scopes will get done. What about those early starting clinics?

As pointed out, perhaps the CEO's and admin will be able to carry the can at lunch when we are all gone.

Oh wait, I have never actually seen one of them in their offices between 12.45 and 2pm in the last 8 years I have been working as a doctor! Hey I notice they always seem non stressed and relaxed. Lads maybe it wont be such a bad thing taking lunch!

sam34

ergo wrote: »

tbh I thought lunch breaks were paid

ie. basic working week is 900-1700 Mon-Thurs and 900-1600 Friday = 39 hours so all time spent in the hospital is paid for, even when sitting in the canteen

in Australia I had an 8 hour day which was 800-1630 with 30 minutes (unpaid) for lunch

sorry, my post was unclear. yes, our basic salary is for 39 hrs a week, which covers 9 to 5 mon to thurs and 9 to 4 on fri. the point i was trying to make was that we very often dont get a lunch break, or even a coffee break. they are making it sound like we down tools and swan off to a nice little restaurant for an hour every day, when this is patently not true. we are being paid for lunch because we usually work part, if not all, of "lunch hour". plus, even if you are in the canteen, you still have the bleep on, and are therefore available.

ronbyrne2005

Recruit a few thousand highly qualified doctors from Poland, Romania , Bulgaria, India etc. Pay them half the current rates and they would be delighted to do the work the Irish doctors do. We have a shortage of doctors here so it makes sense to import the extra neded untill we increase the numbers of Irish medical grads.:pac:

Traumadoc

We already have thousands of non-national doctors, why do you want to cut their pay rates?

Svalbard

ronbyrne2005 wrote: »

Recruit a few thousand highly qualified doctors from Poland, Romania , Bulgaria, India etc. Pay them half the current rates and they would be delighted to do the work the Irish doctors do. We have a shortage of doctors here so it makes sense to import the extra neded untill we increase the numbers of Irish medical grads.:pac:

I can't stand by exact figures, but i read somewhere that over 50% of NCHDs in Ireland are foreign nationals. Why.......

Irish doctors leave the country en masse to complete training a broad because the quality of training is much better in the UK, USA, Australia etc.

So, there are plenty of posts for foreigners that Irish doctors simply will not work in.

Foreign docs can earn lots of money here because they can work crazy amounts of overtime, long banned in other western countries.

By treating NCHDs like garbage, the HSE will succeed in chasing even more Irish docs out of the country (like there were that many to begin with thanks to limited university places to study medicine). And the foreign docs who traditionally met the shortfall will look elsewhere also if the training is terrible, conditions untenable and the pay is bad.

Phototoxin

also the people at the top dont realise what its like on ground level. one hospital discharged all the patients on A&E trollies, overtimed cleaners and even spent about €200 on floral arrangements for him coming on a simple walkabout.

Total JOKE.

Until the minister for health takes a pay cut no one in the health sector should.

The other option is just to grind up everone over 65 for food for the homeless as obviously the health system cannot deal with it*

*gets coat*


*not a real suggestion

NCHD

http://sites.google.com/site/hsecutbacks/
check above link to see how doctors are under fire from HSE.

NCHD