HSE plans to cut doctors overtime

PoleStar

For those who havent heard, the HSE plans to cut all unrostered overtime for junior doctors!

For those who dont understand how a doctors working week works, please let me explain using myself (doing surgery) as an example.

Firstly, junior doctor is a misnomer, it suggest forexample a trainee or student. I am a "junior doctor" but have been working as a doctor for 8.5 years!

Anyway our contract is as for ever other (except managers, nurses, physios, maintenance etc who work less) public service worker i.e. a 39 hours week.

Rostered overtime takes the form of on call duties which for most is 1 day per week and is for a 24 hour period. E.G. if you are on call Tuesday, you start (potentially) at 9 am as usual, come 5pm your official on call work starts and you do emergency work until 9 am the next morning when the next day starts and you leave work (potentially) at 5 pm (by the way, at no time do you go home just to clarify). This will still be paid.

Unrostered overtime is all other extra hours worked. Before the year 2000 this work was done for FREE by junior doctors i.e. if you worked an extra 20 or 30 hours well tough. Now since 2000, just like any other job, e.g. working in MacDonalds, mainenance, porters etc, these extra hours are actually paid.

What are these hours? Well here are a few examples. In my institution, some clinics start at 8am, so thats coming in an extra hour in the morning and should be paid right? Well it would be unrostered hours and thus un-paid. Ok, what about theatre days. Well to get a reasonable number of surgical cases done in a day, theatre starts at 8.30am. Ok so it makes sense that the surgeon actually sees his patients before surgery right? Yes it does. Ok so we come in early, 7 or 7.30 to see these patients to confirm the appropriate treatment is being performed, the patient still needs the operation or isnt sick with a flu or something etc to ensure they still should have the operation. This is unrostered overtime so will not be paid. Ok, what about when theatre finishes at maybe 5 pm. After having an operation you might like to have your doctor check that you are ok right? Damn right yes! Well this is what happens. The result is that the doctor maybe leaves at 7pm. This is unrostered overtime and the HSE plans to stop paying for this.

These are the 2 options as I see it.

1. The HSE expects doctors to provide patient services and continue working these hours for free. Now doctors represent an easy target as there are frequent media reports of junior doctors getting paid exorbitant amounts. Well lets look at the facts. A junior doctor (based on level of experience) gets a basic salary of between approx 30 to 50 k (the 50 k end is usually someone who has put in quite a few years of work). Not really an excessive amount and on a par with other health service workers. If they earn big salaries its because of the number of hours. If a nurse or porter of kitchen staff worked those hours well then such payments are available to them! This cannot happen. I work approx 70-90 hours per week and as a result miss out on social life, seeing my child grow up etc. Now I love my job and am prepared to do this. However I do think for making this major sacrifice in my life I should actually be paid for it and not work FOR FREE.

2. The HSE expects junior doctors to actually cut out this unrostered overtime. This will only happen by cutting operating lists, reducing clinics and reducing patient care. If I am due to finish call at 9am Saturday well thats when we will leave. What about the patients at the weekend who need scans booked etc? Well I guess that wont be happening.

What the public dont realise is that doctors overtime is actually part of their normal workin week, just happens to be quite a long week for them. If they plan to cut overtime, they should really come out and say it as follows "The HSE plans to cut the number of hours that doctors are available to care for patients"

Afterall, I dont spend those overtime hours filling in paperwork, or forms or whatever, its actually doing work on PATIENTS.


Please spread the word. If this is actually implemented, those waiting lists have to go up. Those patients that need urgent colonoscopies? They can wait. What about clinics? Well I guess clinic numbers will have to be cut.

Why can the HSE do this? Easy. Smaller clinics, less operations, less investigations, less scope tests: means less cost for HSE.

AND WHO TO BLAME: Yes, lets blame the doctor. This would not happen with any other staff grade. Do you think it would be acceptable for the HSE to say "Lets cut nurses hours"? No definitely not. However because part of the doctors NORMAL working week is overtime, they think its ok to do it.

And yet, since any of these cuts have occured, I dont see mention ANYWHERE that a single bonus for HSE manager or single middle grade management job wil be reduced.

PLEASE SPREAD THE WORD. THE HSE IS PLANNING TO DRASTICALLY CUT THE HEALTH SERVICE BY STEALTH.

Please reply and show your support.

Bison

Good post. You should put it in the national newspapers also.

onetrueone

The HSE are trying to bully your profession just as they tried to do with the Pharmacists.
They are trying to take advantage of your caring/professional nature and use you as a scapegoat for their own mismanagement of the Health service.
Would you see any of the managment at the HSE doing any unpaid work?
Come to think of it it's highly unlikely that you would see the HSE crowd doing any work at all! .
You and your colleagues must stand your ground and FACE DOWN THE HSE BULLIES!
Hopefully this will further expose Harney and the HSE as the incompetent clowns they are.
I would support you if you felt the need to exercise industrial action measures.
Thank you for your informative post.
Good luck a chara.

Lamaat

Junior doctor is a wrong term. Front Line Hospiatl Doctor sounds better

drzhivago

PoleStar wrote: »

For those who havent heard, the HSE plans to cut all unrostered overtime for junior doctors!

For those who dont understand how a doctors working week works, please let me explain using myself (doing surgery) as an example.

Firstly, junior doctor is a misnomer, it suggest forexample a trainee or student. I am a "junior doctor" but have been working as a doctor for 8.5 years!

Anyway our contract is as for ever other (except managers, nurses, physios, maintenance etc who work less) public service worker i.e. a 39 hours week.

Rostered overtime takes the form of on call duties which for most is 1 day per week and is for a 24 hour period. E.G. if you are on call Tuesday, you start (potentially) at 9 am as usual, come 5pm your official on call work starts and you do emergency work until 9 am the next morning when the next day starts and you leave work (potentially) at 5 pm (by the way, at no time do you go home just to clarify). This will still be paid.

Unrostered overtime is all other extra hours worked. Before the year 2000 this work was done for FREE by junior doctors i.e. if you worked an extra 20 or 30 hours well tough. Now since 2000, just like any other job, e.g. working in MacDonalds, mainenance, porters etc, these extra hours are actually paid.

What are these hours? Well here are a few examples. In my institution, some clinics start at 8am, so thats coming in an extra hour in the morning and should be paid right? Well it would be unrostered hours and thus un-paid. Ok, what about theatre days. Well to get a reasonable number of surgical cases done in a day, theatre starts at 8.30am. Ok so it makes sense that the surgeon actually sees his patients before surgery right? Yes it does. Ok so we come in early, 7 or 7.30 to see these patients to confirm the appropriate treatment is being performed, the patient still needs the operation or isnt sick with a flu or something etc to ensure they still should have the operation. This is unrostered overtime so will not be paid. Ok, what about when theatre finishes at maybe 5 pm. After having an operation you might like to have your doctor check that you are ok right? Damn right yes! Well this is what happens. The result is that the doctor maybe leaves at 7pm. This is unrostered overtime and the HSE plans to stop paying for this.

These are the 2 options as I see it.

1. The HSE expects doctors to provide patient services and continue working these hours for free. Now doctors represent an easy target as there are frequent media reports of junior doctors getting paid exorbitant amounts. Well lets look at the facts. A junior doctor (based on level of experience) gets a basic salary of between approx 30 to 50 k (the 50 k end is usually someone who has put in quite a few years of work). Not really an excessive amount and on a par with other health service workers. If they earn big salaries its because of the number of hours. If a nurse or porter of kitchen staff worked those hours well then such payments are available to them! This cannot happen. I work approx 70-90 hours per week and as a result miss out on social life, seeing my child grow up etc. Now I love my job and am prepared to do this. However I do think for making this major sacrifice in my life I should actually be paid for it and not work FOR FREE.

2. The HSE expects junior doctors to actually cut out this unrostered overtime. This will only happen by cutting operating lists, reducing clinics and reducing patient care. If I am due to finish call at 9am Saturday well thats when we will leave. What about the patients at the weekend who need scans booked etc? Well I guess that wont be happening.

What the public dont realise is that doctors overtime is actually part of their normal workin week, just happens to be quite a long week for them. If they plan to cut overtime, they should really come out and say it as follows "The HSE plans to cut the number of hours that doctors are available to care for patients"

Afterall, I dont spend those overtime hours filling in paperwork, or forms or whatever, its actually doing work on PATIENTS.


Please spread the word. If this is actually implemented, those waiting lists have to go up. Those patients that need urgent colonoscopies? They can wait. What about clinics? Well I guess clinic numbers will have to be cut.

Why can the HSE do this? Easy. Smaller clinics, less operations, less investigations, less scope tests: means less cost for HSE.

AND WHO TO BLAME: Yes, lets blame the doctor. This would not happen with any other staff grade. Do you think it would be acceptable for the HSE to say "Lets cut nurses hours"? No definitely not. However because part of the doctors NORMAL working week is overtime, they think its ok to do it.

And yet, since any of these cuts have occured, I dont see mention ANYWHERE that a single bonus for HSE manager or single middle grade management job wil be reduced.

PLEASE SPREAD THE WORD. THE HSE IS PLANNING TO DRASTICALLY CUT THE HEALTH SERVICE BY STEALTH.

Please reply and show your support.

16 years qualified (still a Junior doctor) and I am afraid its much worse than you are making out

Many of us have to pay for the privilege of going to work. Our jobs are tied to training in a specialty. there is a fee attached to this which we have to pay, for some €3,200 per year. At present this can be refunded through a training grant, you pay money out for training needs and you get it refunded on vouched expenses. This has to be pre-authorised by a hospital manager in the first place

Now the catch 22 is you cant have the job unless you pay the fee. Now you will have to pay the fee from your after tax income

We will be the only ones who have to pay money from their own pocket for the privilege of going to work in the public services.

drzhivago

Lamaat wrote: »

Junior doctor is a wrong term. Front Line Hospiatl Doctor sounds better

FACT
there are over 100 junior doctors (Front Line Hospital doctors/Non Consultant Hospital doctors) in the health service aged over 50 years of age

When people hear junior they think 23/24/25 or something like that

We are an aging bunch and not so willing to be pushed around anymore

Vorsprung

I just read Sean McGrath's reply that Med HR forwarded. To say that I'm raging is an understatement.

AmcD

There is very little coverage of the NCHD slashbacks, but why can't news presenters check their facts or correct the HSE???

1. Doctors do not get paid overtime for lunch

2. Very few doctors take more than a few minutes for lunch and if they do, they are constantly available to work due to their bleeps.

3. The HSE are cutting overtime rates as well as refusing to pay for hours that are "unrostered".

4. Overtime is mandatory. This is not a cushy optional number.

I am so glad I have left NCHD land. I used to check my payslip every month and while I found plenty of mistakes, I never found any in my favour. I am not sure I could cheerfully work for free

drzhivago

AmcD wrote: »

There is very little coverage of the NCHD slashbacks, but why can't news presenters check their facts or correct the HSE???
1. Doctors do not get paid overtime for lunch
2. Very few doctors take more than a few minutes for lunch and if they do, they are constantly available to work due to their bleeps.
3. The HSE are cutting overtime rates as well as refusing to pay for hours that are "unrostered".
4. Overtime is mandatory. This is not a cushy optional number.
I am so glad I have left NCHD land. I used to check my payslip every month and while I found plenty of mistakes, I never found any in my favour. I am not sure I could cheerfully work for free

Agree with news presenters but very difficult to get them to take everything in

Regarding Lunch pm me and I wille xplain more not a talk for this open board

Regarding your paycheques do you still have them, do you have your time sheets, there is quite a simple process to recover this money if you were actually due it and it falls within the right time frame

PM me for more information

AmcD

As regards my payslips, thanks for asking, but I got all wages due to me. I checked my payslip against a copy of hours submitted every time I collected my payslip. If there was a problem I got the salaries people to correct it on the spot. OCD can be useful.

drzhivago

AmcD wrote: »

As regards my payslips, thanks for asking, but I got all wages due to me. I checked my payslip against a copy of hours submitted every time I collected my payslip. If there was a problem I got the salaries people to correct it on the spot. OCD can be useful.

I will bet you a penny you have never been paid what you were owed

I have yet to find an NCHD whose pay cheque reflected what their legal wages entitlements were

Labour relations Commission even set up a body 9 years ago to examine junior doctors wages and found that in almost every case presented doctors were owed significant amounts of money

One hospital even went so far as to calculate what was owed to the doctors that worked there for a 3 years instead of waiting and working it out one by one.

Only 30% of the doctors were in the country any more so most could not benefit from it but it goes to show you

Not one manager was reprimanded for this afterwards, should have been a national scandal

That mentality never went away though and many groups of managers resented actually having to pay the NCHDs for all ours worked which is why we are where we are now

Jane5

Dr. Zhivago,

Do you know if there is a limit on how long after the fact you can claim back pay for hours worked if you were not paid all you were owed?

drzhivago

Jane5 wrote: »

Dr. Zhivago,

Do you know if there is a limit on how long after the fact you can claim back pay for hours worked if you were not paid all you were owed?

Yes
in the normal course of events under Payment of Wages Act it is 6 months
This can be extended to 1year under extenuating circumstances for the Individual

However if there was shown to be an institutional fraud there would potentially be grounds to look back longer, have discussed this with a few barrister colleagues of similar college vintage to myself who are now Junior and Senior counsel

PM me for more details dont need to know names but if you indicate hospitals i can give you some ideas

drzhivago

Jane5 wrote: »

Dr. Zhivago,

Do you know if there is a limit on how long after the fact you can claim back pay for hours worked if you were not paid all you were owed?

Apologies my last post was not complete 6 months/12 months refers to the times when you can progress a claim with rights commissioners, the easiest non legal way

6 years i the time frame to progress a case through courts so presume you are within this, depending on the amount of money it could be district court/circuit court (there are different waiting times for the two)

~

Jane5

Cool, thanks Dr. Zhivago!
It's been two years, so am well within that timeframe.

drzhivago

Jane5 wrote: »

Cool, thanks Dr. Zhivago!
It's been two years, so am well within that timeframe.

check your message have replied with more detail

There is a campaign going on this at present

drzhivago

HSE has been taken to high court by IMO and 6 doctors, apparently also over 500 letters from other doctors considering own legal action

I think Sean McGrath has a lot to answer for

If this case is lost his position is untenable as director of human resources

He has come in on a salary package way above that proposed for the job (8 times higher than some of the junior doctors he is trying to shaft)

He has succeeded in getting a generally very quiet bunch to vote for Industrial action

He will have cost the HSE and by extension the State millions and possibly hundreds of millions if the doctors proceed with their legal actions as he and his staff have forced them to work beyond the legal limit of hours on a daily and weekly basis. In some cases they have paid for the hours worked and in others not

How could he remain in post-- OUT OUT OUT

adamwest1

These NCHD cutbacks are absolutely ridiculous. I cant say I'm surprised however. Doctors in general put up with crap the whole time - half the time we are so bloody sleep deprived its a wonder we are not ourselves involved in an RTA on the way home. We put up with crap from everyone - nurses, physios, some mental consultants who seem to all reside in the oncology sector.

We work god forsaken hours. I dont know about you but I have never had a full hour to eat lunch. Im lucky if I can grab something on the go. In my oncology days I had no lunch and was kicked around like a dead rodent by everybody and I was expected to be on call three bloody times a week. I would have thought that that by itself would have infringed on human rights!

I wanted to do something about it but couldnt find anyone else who was bothered to complain or demand better. Nobody complained then and its because we didnt take action sooner that now they are bloody well going for the jugular and taking away our pay, our training grant, our living out allowance and our higher education pay. Remember that the training grant was originally given to us in lieu of a pay raise - and when we had it they didnt just hand it over instead they made us beg for it - keep receipts - get signatures from consultants and some hospitals kicked up a fuss when it came to paying out - and this was in lieu of our pay rise so we bloody well deserved it all and not just part of it - and if we didnt claim it all we didnt get it all - again our pay rise.

Its amazing that globally doctors seem to slot into a role of a punch bag of sorts putting up with anything - even in the states where most of the population are quick to demand better conditions and great services - the world over doctors seem to not be capable of demanding better for themselves. Its also ridiculous that as doctors here we dont have free medical and dental - we need good health to maintain good health.

Also if you notice the nursing staff have the cohones to strike - they have nicer working hours and per hour worked probobly earn what we do. They dont dare piss off the nurses cause they know theyll retaliate. Even our doctors residences in the hospitals suck. Most of the ones Ive seen are not actual buildings but prefabs and are rodent and insect infested.

The reason why it has got so bad is 1) we didnt do anything sooner 2) we are too bloody scared to strike and they know that - we are being coersed - they know we cant really strike cause there would be dire consequences however we just have to ask ourselves - are we prepared to put up with this crap - how bad do we need to let it get or are we just going to keep settling for less and less. The sheer reduction of it all!!

I wouldnt mind ireland is not even a great place for training. Usually if you want to get along you have to leave the country. Also we are being treated like crap in other ways such as: if you are lucky to get on a scheme you have to go to maybe 4-6 different hospitals over a two year period for 3-6month rotations - and this is if you are lucky. These hospitals can be scattered around the bloody country and so involve uprooting yourself like a frekkin nomad not to mention uprooting family if you are married. In fact i believe many of us dont have families or get married or only marry docs cause its too difficult otherwise. Partners think you are cheating if you keep saying you are on call the whole time if they themselves are not in medicine they dont tend to understand and relationship end.

If you were unfortunate and didnt get on a scheme you are left looking for a new bloody job every 6 bloody months. As soon as you start a job you are applying for another. This continues on. If you are lucky you get onto an spr scheme but of course there are only a handful available. You could spend many years going around and getting nowhere. many people get dissillusioned and quit late in the game.

Also as a doctor making important decisions i need my bloody sleep, i require hydration and nutrition - im not a bloody secretary who can just tippex out an error. Secretaries get a full nights sleep however but i dont. I'm a human who needs rest, food, water and shelter like all others.Also i read somewhere that our average pay for nchd is 100K. What the fu**! Is anyone getting that? I never got that. Are they out of their minds?Many doctors will be faced with mortgage difficulties with these cutbacks. How many years of study and work again did i put into this career and to get where - here - this ridiculous situation - this crap.

Yes - this is a rant - im pissed

Jane5

adamwest1 wrote: »

These NCHD cutbacks are absolutely ridiculous. I cant say I'm surprised however. Doctors in general put up with crap the whole time - half the time we are so bloody sleep deprived its a wonder we are not ourselves involved in an RTA on the way home. We put up with crap from everyone - nurses, physios, some mental consultants who seem to all reside in the oncology sector.

We work god forsaken hours. I dont know about you but I have never had a full hour to eat lunch. Im lucky if I can grab something on the go. In my oncology days I had no lunch and was kicked around like a dead rodent by everybody and I was expected to be on call three bloody times a week. I would have thought that that by itself would have infringed on human rights!

I wanted to do something about it but couldnt find anyone else who was bothered to complain or demand better. Nobody complained then and its because we didnt take action sooner that now they are bloody well going for the jugular and taking away our pay, our training grant, our living out allowance and our higher education pay. Remember that the training grant was originally given to us in lieu of a pay raise - and when we had it they didnt just hand it over instead they made us beg for it - keep receipts - get signatures from consultants and some hospitals kicked up a fuss when it came to paying out - and this was in lieu of our pay rise so we bloody well deserved it all and not just part of it - and if we didnt claim it all we didnt get it all - again our pay rise.

Its amazing that globally doctors seem to slot into a role of a punch bag of sorts putting up with anything - even in the states where most of the population are quick to demand better conditions and great services - the world over doctors seem to not be capable of demanding better for themselves. Its also ridiculous that as doctors here we dont have free medical and dental - we need good health to maintain good health.

Also if you notice the nursing staff have the cohones to strike - they have nicer working hours and per hour worked probobly earn what we do. They dont dare piss off the nurses cause they know theyll retaliate. Even our doctors residences in the hospitals suck. Most of the ones Ive seen are not actual buildings but prefabs and are rodent and insect infested.

The reason why it has got so bad is 1) we didnt do anything sooner 2) we are too bloody scared to strike and they know that - we are being coersed - they know we cant really strike cause there would be dire consequences however we just have to ask ourselves - are we prepared to put up with this crap - how bad do we need to let it get or are we just going to keep settling for less and less. The sheer reduction of it all!!

I wouldnt mind ireland is not even a great place for training. Usually if you want to get along you have to leave the country. Also we are being treated like crap in other ways such as: if you are lucky to get on a scheme you have to go to maybe 4-6 different hospitals over a two year period for 3-6month rotations - and this is if you are lucky. These hospitals can be scattered around the bloody country and so involve uprooting yourself like a frekkin nomad not to mention uprooting family if you are married. In fact i believe many of us dont have families or get married or only marry docs cause its too difficult otherwise. Partners think you are cheating if you keep saying you are on call the whole time if they themselves are not in medicine they dont tend to understand and relationship end.

If you were unfortunate and didnt get on a scheme you are left looking for a new bloody job every 6 bloody months. As soon as you start a job you are applying for another. This continues on. If you are lucky you get onto an spr scheme but of course there are only a handful available. You could spend many years going around and getting nowhere. many people get dissillusioned and quit late in the game.

Also as a doctor making important decisions i need my bloody sleep, i require hydration and nutrition - im not a bloody secretary who can just tippex out an error. Secretaries get a full nights sleep however but i dont. I'm a human who needs rest, food, water and shelter like all others.Also i read somewhere that our average pay for nchd is 100K. What the fu**! Is anyone getting that? I never got that. Are they out of their minds?Many doctors will be faced with mortgage difficulties with these cutbacks. How many years of study and work again did i put into this career and to get where - here - this ridiculous situation - this crap.

Yes - this is a rant - im pissed

Beautifully put, Adam West. Rest assured there are plenty around now who are on for doing something about it! Things were freakin' terrible BEFORE they began trying to implement these cutbacks. Now the job is actually unworkable.